Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

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Dr Bhanu K Bhakhri

"The Journal of Clinical and Diagnostic Research (JCDR) has been in operation since almost a decade. It has contributed a huge number of peer reviewed articles, across a spectrum of medical disciplines, to the medical literature.
Its wide based indexing and open access publications attracts many authors as well as readers
For authors, the manuscripts can be uploaded online through an easily navigable portal, on other hand, reviewers appreciate the systematic handling of all manuscripts. The way JCDR has emerged as an effective medium for publishing wide array of observations in Indian context, I wish the editorial team success in their endeavour"



Dr Bhanu K Bhakhri
Faculty, Pediatric Medicine
Super Speciality Paediatric Hospital and Post Graduate Teaching Institute, Noida
On Sep 2018




Dr Mohan Z Mani

"Thank you very much for having published my article in record time.I would like to compliment you and your entire staff for your promptness, courtesy, and willingness to be customer friendly, which is quite unusual.I was given your reference by a colleague in pathology,and was able to directly phone your editorial office for clarifications.I would particularly like to thank the publication managers and the Assistant Editor who were following up my article. I would also like to thank you for adjusting the money I paid initially into payment for my modified article,and refunding the balance.
I wish all success to your journal and look forward to sending you any suitable similar article in future"



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Professor & Head,
Department of Dematolgy,
Believers Church Medical College,
Thiruvalla, Kerala
On Sep 2018




Prof. Somashekhar Nimbalkar

"Over the last few years, we have published our research regularly in Journal of Clinical and Diagnostic Research. Having published in more than 20 high impact journals over the last five years including several high impact ones and reviewing articles for even more journals across my fields of interest, we value our published work in JCDR for their high standards in publishing scientific articles. The ease of submission, the rapid reviews in under a month, the high quality of their reviewers and keen attention to the final process of proofs and publication, ensure that there are no mistakes in the final article. We have been asked clarifications on several occasions and have been happy to provide them and it exemplifies the commitment to quality of the team at JCDR."



Prof. Somashekhar Nimbalkar
Head, Department of Pediatrics, Pramukhswami Medical College, Karamsad
Chairman, Research Group, Charutar Arogya Mandal, Karamsad
National Joint Coordinator - Advanced IAP NNF NRP Program
Ex-Member, Governing Body, National Neonatology Forum, New Delhi
Ex-President - National Neonatology Forum Gujarat State Chapter
Department of Pediatrics, Pramukhswami Medical College, Karamsad, Anand, Gujarat.
On Sep 2018




Dr. Kalyani R

"Journal of Clinical and Diagnostic Research is at present a well-known Indian originated scientific journal which started with a humble beginning. I have been associated with this journal since many years. I appreciate the Editor, Dr. Hemant Jain, for his constant effort in bringing up this journal to the present status right from the scratch. The journal is multidisciplinary. It encourages in publishing the scientific articles from postgraduates and also the beginners who start their career. At the same time the journal also caters for the high quality articles from specialty and super-specialty researchers. Hence it provides a platform for the scientist and researchers to publish. The other aspect of it is, the readers get the information regarding the most recent developments in science which can be used for teaching, research, treating patients and to some extent take preventive measures against certain diseases. The journal is contributing immensely to the society at national and international level."



Dr Kalyani R
Professor and Head
Department of Pathology
Sri Devaraj Urs Medical College
Sri Devaraj Urs Academy of Higher Education and Research , Kolar, Karnataka
On Sep 2018




Dr. Saumya Navit

"As a peer-reviewed journal, the Journal of Clinical and Diagnostic Research provides an opportunity to researchers, scientists and budding professionals to explore the developments in the field of medicine and dentistry and their varied specialities, thus extending our view on biological diversities of living species in relation to medicine.
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As an experienced dentist and an academician, I proudly recommend this journal to the dental fraternity as a good quality open access platform for rapid communication of their cutting-edge research progress and discovery.
I wish JCDR a great success and I hope that journal will soar higher with the passing time."



Dr Saumya Navit
Professor and Head
Department of Pediatric Dentistry
Saraswati Dental College
Lucknow
On Sep 2018




Dr. Arunava Biswas

"My sincere attachment with JCDR as an author as well as reviewer is a learning experience . Their systematic approach in publication of article in various categories is really praiseworthy.
Their prompt and timely response to review's query and the manner in which they have set the reviewing process helps in extracting the best possible scientific writings for publication.
It's a honour and pride to be a part of the JCDR team. My very best wishes to JCDR and hope it will sparkle up above the sky as a high indexed journal in near future."



Dr. Arunava Biswas
MD, DM (Clinical Pharmacology)
Assistant Professor
Department of Pharmacology
Calcutta National Medical College & Hospital , Kolkata




Dr. C.S. Ramesh Babu
" Journal of Clinical and Diagnostic Research (JCDR) is a multi-specialty medical and dental journal publishing high quality research articles in almost all branches of medicine. The quality of printing of figures and tables is excellent and comparable to any International journal. An added advantage is nominal publication charges and monthly issue of the journal and more chances of an article being accepted for publication. Moreover being a multi-specialty journal an article concerning a particular specialty has a wider reach of readers of other related specialties also. As an author and reviewer for several years I find this Journal most suitable and highly recommend this Journal."
Best regards,
C.S. Ramesh Babu,
Associate Professor of Anatomy,
Muzaffarnagar Medical College,
Muzaffarnagar.
On Aug 2018




Dr. Arundhathi. S
"Journal of Clinical and Diagnostic Research (JCDR) is a reputed peer reviewed journal and is constantly involved in publishing high quality research articles related to medicine. Its been a great pleasure to be associated with this esteemed journal as a reviewer and as an author for a couple of years. The editorial board consists of many dedicated and reputed experts as its members and they are doing an appreciable work in guiding budding researchers. JCDR is doing a commendable job in scientific research by promoting excellent quality research & review articles and case reports & series. The reviewers provide appropriate suggestions that improve the quality of articles. I strongly recommend my fraternity to encourage JCDR by contributing their valuable research work in this widely accepted, user friendly journal. I hope my collaboration with JCDR will continue for a long time".



Dr. Arundhathi. S
MBBS, MD (Pathology),
Sanjay Gandhi institute of trauma and orthopedics,
Bengaluru.
On Aug 2018




Dr. Mamta Gupta,
"It gives me great pleasure to be associated with JCDR, since last 2-3 years. Since then I have authored, co-authored and reviewed about 25 articles in JCDR. I thank JCDR for giving me an opportunity to improve my own skills as an author and a reviewer.
It 's a multispecialty journal, publishing high quality articles. It gives a platform to the authors to publish their research work which can be available for everyone across the globe to read. The best thing about JCDR is that the full articles of all medical specialties are available as pdf/html for reading free of cost or without institutional subscription, which is not there for other journals. For those who have problem in writing manuscript or do statistical work, JCDR comes for their rescue.
The journal has a monthly publication and the articles are published quite fast. In time compared to other journals. The on-line first publication is also a great advantage and facility to review one's own articles before going to print. The response to any query and permission if required, is quite fast; this is quite commendable. I have a very good experience about seeking quick permission for quoting a photograph (Fig.) from a JCDR article for my chapter authored in an E book. I never thought it would be so easy. No hassles.
Reviewing articles is no less a pain staking process and requires in depth perception, knowledge about the topic for review. It requires time and concentration, yet I enjoy doing it. The JCDR website especially for the reviewers is quite user friendly. My suggestions for improving the journal is, more strict review process, so that only high quality articles are published. I find a a good number of articles in Obst. Gynae, hence, a new journal for this specialty titled JCDR-OG can be started. May be a bimonthly or quarterly publication to begin with. Only selected articles should find a place in it.
An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help one’s reviewing skills.
My best wishes to Dr. Hemant Jain and all the editorial staff of JCDR for their untiring efforts to bring out this journal. I strongly recommend medical fraternity to publish their valuable research work in this esteemed journal, JCDR".



Dr. Mamta Gupta
Consultant
(Ex HOD Obs &Gynae, Hindu Rao Hospital and associated NDMC Medical College, Delhi)
Aug 2018




Dr. Rajendra Kumar Ghritlaharey

"I wish to thank Dr. Hemant Jain, Editor-in-Chief Journal of Clinical and Diagnostic Research (JCDR), for asking me to write up few words.
Writing is the representation of language in a textual medium i e; into the words and sentences on paper. Quality medical manuscript writing in particular, demands not only a high-quality research, but also requires accurate and concise communication of findings and conclusions, with adherence to particular journal guidelines. In medical field whether working in teaching, private, or in corporate institution, everyone wants to excel in his / her own field and get recognised by making manuscripts publication.


Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."



Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011




Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."



Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011

Important Notice

Case report
Year : 2011 | Month : December | Volume : 5 | Issue : 8 | Page : 1659 - 1661

The Cytology of the Benign Extra- Gastrointestinal Stromal Tumour in the Pouch of Douglas: A Case Report

B. Devanand, Vadiraj P.

1. Professor, Medical College (VIMS), Bellary - 583104 Karnataka, India. 2. Consultant No.18, KHB Colony Gandhinagar, Near Women’s college Bellary, Karnataka, India - 583 103.

Correspondence Address :
Vadiraj P., Consultant
No.18, KHB Colony
Gandhinagar, Near Women’s college
Bellary, India - 583 103
pyativadiraj@gmail.com

Abstract

Extra-gastrointestinal stromal tumours are rare, non-epithelial, mesenchymal tumours which arise from the soft tissues of the abdomen- mesentry, the omentum and the retroperitoneum. These tumours are histologically and cytologically similar to the stromal tumours of the gastrointestinal tract, they are composed of purely rounded epithelioid cells or short fusiform cells or a mixture of both and are set in a fine fibrillary myxiod background. The cytological features of the imprint smears in a case of benign extra-gastrointestinal stromal tumour of the mesentry, projecting into the pouch of douglas in a 42-year old female, have been described here. The recognition of these tumours is important because of their aggressive biological behaviour. The metastatic potential and the high rate of recurrence of these tumours necessitate the frequent follow up of the patients after a surgical resection.

Keywords

Epithelioid, extra-gastrointestinal, spindle, stromal tumour

How to cite this article :

B. Devanand, Vadiraj P.. THE CYTOLOGY OF THE BENIGN EXTRA- GASTROINTESTINAL STROMAL TUMOUR IN THE POUCH OF DOUGLAS: A CASE REPORT. Journal of Clinical and Diagnostic Research [serial online] 2011 December [cited: 2019 Oct 20 ]; 5:1659-1661. Available from
http://www.jcdr.net/back_issues.asp?issn=0973-709x&year=2011&month=December&volume=5&issue=8&page=1659-1661&id=1787

Introduction
Extra-gastrointestinal stromal tumours (EGISTs) are very rare tumours, accounting for less than 10% of the stromal tumours which arise in the gastro-intestinal tract (1). They constitute a group of primary non-epithelial mesenchymal tumours which arise outside the gastrointestinal tract in the soft tissues of the abdomen like the mesentry omentum and the retroperitoneum, with the exclusion of the tumours which arise in the gastro-intestinal tract and the exclusion of those having the classic features of leiomyoma, leiomyosarcoma, schwannoma and other fibromatoses. These tumours are believed to arise from the primitive stromal cells which are capable of differentiating into intestinal smooth muscle or neural cells, because some of these tumours show positivity for the smooth muscle and neural markers.

The cytology of a case of benign extra-gastrointestinal tumour in a 42-year-old female has been presented here.

Case Report

A 42-year-old, premenopausal, multiparous female presented with lower abdominal pain of 3 months duration. The general physical examination was normal. The per-abdominal examination revealed no palpable mass, except for tenderness in the right iliac fossa. The per-vaginal examination showed a tender right fornix, a bulky uterus and fullness in the pouch of douglas. The other systems were normal. Ultrasound examination of the lower abdomen showed a right sided pyosalphinx and a hypoechoic mass in the posterior aspect of the uterus. Abdominal hysterectomy with bilateral salphingo-oopherectomy was done. Per-operatively, a solid tumour which measured 6×4 cms, which arose from the mesentry and was protruding into the pouch of douglas, was made out. This mass was not attached to the gastrointestinal tract or to the genitourinary organs. The mass was enucleated and sent separately for histopathological examination.

The mass was well circumscribed and unencapsulated. The cut section showed a smooth, lobulated and tanned appearance withsolid, cystic and haemorrhagic areas. Imprint smears of the unfixed specimen were taken, fixed in ethyl alcohol and stained with the hematonylin- eosin (H and E) stains.

The cytology revealed many tissue fragments which consisted of loose spindle cells in a myxoid fibrillary background. These spindle cells which had ill-defined cytoplasm were arranged as fascicles or palisades, with spindle or cigar shaped nuclei, with pointed or blunt ends, with finely dispersed chromatin and indistinct nucleoli [Table/ Fig 1 and (Table/Fig 2). Areas showing loosely cohesive sheets of oval or polygonal cells with moderate, well defined cytoplasm and round hyperchromatic nuclei with granular chromatin and nucleoli, which represented an epithelioid morphology were seen (Table/Fig 2). Extra cellular, amorphous eosinophilic material with few spindle cells, which represented skenoid fibres (Table/Fig 2) and many stripped nuclei (Table/Fig 3) were seen. The diagnosis of stromal tumour of extra-gastrointestinal origin was suggested.

The haematoxylin and eosin stained paraffin sections showed interlacing fascicles of benign spindle cells with eosinophilic fibrillary cytoplasm and cigar shaped nuclei. There was no nuclear pleomorphism, mitoses or necrosis. A histopathological diagnosis of extra-gastrointestinal stromal tumour was made and it correlated with the cytology. Immunohistochemistry of the tumour showed positivity for CD (1).

Discussion

Stromal tumours which arise outside the gastro-intestinal tract are very rare (1). These tumours arise from the soft tissues of abdomenmesentry, the omentum and theretroperitoneum. EGISTs have been extensively analyzed by Reith et al (1). EGISTs have been documented in various sites like the omentum, the pancreas and the vulvoviginal and the rectovaginal septa (2) .

Extra-gastro-intestinal stromal tumours (EGIST) are cytologically and histologically similar to gastro-intestinal stromal tumours which are cellular spindle cell or epithelioid tumours which express the CD 34 and the CD 117 (c-kit) antigens (5). EGISTs display various lines of differentiation which reflect the elements of the gut wall, showing differentiation towards smooth muscle and neural elements, dual differentiation and those that lack differentiation towards either cell type (6).EGISTs occur commonly in adults, presenting with abdominal pain or are discovered incidentally during a work up for an unrelated condition (1).

Grossly, these tumours tend to be lobulated, nodular, well circumscribed and unencapsulated with a smooth fleshy, whorledsilk appearance on cut sections. Areas of necrosis and haemorrhage are common in the malignant tumours (6).

Morphologically, EGISTs are sub-classified to be of the spindle or epithelioid types (5). The cytology of these tumours have been described by Mills and Contos (7). The aspirate smears are moderately cellular and are composed of both tight three- dimensional aggregates and noncohesive single cells which are dispersed in a relatively clean background. The nuclei are spindle shaped orepithelioid with a smooth nuclear membrane and they are evenly distributed, with finely granular chromatin and inconspicuous nucleoli. The cytoplasm is cyanophilic, delicate and fibrillar, with long tapered ends. Extra-cellular fibrillary matrix material is usually present. Skenoid fibres, which are not common markers in EGISTs, were found in our case. Additional morphological variations like a prominent myxoid matrix, a signet ring cell, granular cell features and oncocytic cytoplasmic features have been described (6).

The spindle type of EGISTs should be differentiated from solitary fibrous tumours, fibromatosis, inflammatory fibroid tumours, schwannomas, leiomyomas and leiomyosarcomas (6). The epithelioid type of EGISTs should be distinguished from carcinomas, neuroendocrine tumours, melanomas and hepatocellular carcinomas (8).

The cytological features which predict the adverse outcomes are mitotic activity, cellularity and necrosis. Cytology can be used to diagnose EGISTs, but it is not reliable for assessing the malignant potential (9). A histopathological examination is mandatory for all cases of EGISTs.

EGISTs are an aggressive group of stromal tumours with a malignant potential and a high rate of recurrence (1), (4). But our case had a benign cytology. The malignant EGISTs metastasize to the lung, liver and other organs (6).

EGISTs are treated by surgical resection and the administration of tyrosine kinase inhibitors, with frequent follow ups to detect the recurrence (6).

To conclude, EGISTs are very rare aggressive tumours with high metastatic potential and a high recurrence rate. Cytology can be used as a confident diagnostic tool to detect these tumours. Histological examination is mandatory for the assessment of the malignancy to detect parameters like cellularity, mitoses, anaplasia, pleomophism and necrosis.

References

1.
Reith JD, Goldblum JR, Lyles RH and Weiss SW. Extra-gastrointestinal (soft tissue) stromal tumours: An analysis of 48 cases with an emphasis on the histological predicton of the out come. Mod Pathol 2000; 13(5): 577-85.
2.
Sang MC, Mancho S, Trang AW, Goiman B, Almaroof B and Ahmed MY. A malignant omental extragastrointestinal stromal tumour in a young man: a case report and review of literature. Wor J Surg oncol 2008; 6:50 doi: 10.
3.
Padhi. S, Kongara R, Uppin SG, Uppin MS, Prayaga AK, Challa S et al. Extra-gastrointestinal stromal tumour arising in the pancreas: A case report with a review of the literature. J Pancreas (online) 2010;11(3) :244-8.
4.
Lam MM, Corlen CL, Goldblum JR, Heinrich MC, Downs-kelly E, Rubin BP. Extra-gastrointestinal stromal tumours presenting as vulvovaginal / rectovaginal septal masses: a diagnostic pitfall. Int J. Gynecol Pathol 2006; 25(3):288-92
5.
Deshpande A, Munshi MM. Gastro-intestinal stromal tumours-report of 2007; 24: 96-100.
6.
Rosai J. Gastro-intestinal System: Stomach In Juan Rosai editors, Rosai and Ackerman’s Surgical Pathology 9th ed. Vol1. India: Thomson Press, Mosby (Elsevier); 2004; 674-78
7.
Mills AS, Contos MJ, Goel R. The stomach: In Silverberg SG, DeLellis RA, Frable WJ, LiVolsi VA, Wick MR editors. Silverberg’s Principles and Practice of Surgical Pathology and Cytopathology 4th ed. Vol 2 China : Churchill Livingstone (Elsevier) : 2006; 1345-8.
8.
Dong Q, Mckee G, Pitman M, Geisinger K Tambouret R. Epithelioid variant of gastrointestinal stromal tumour: Diagnasis by fine-needle aspiration. Diagn Cytopathol 2003;29:55-60.
9.
Gu M, Ghafari S, Nguyen PT et al. Cytologic diagnosis of gastrointestinal stromal tumours of the stomach by endoscopic, ultrasound-guided, fine-needle aspiration biopsy. Cytomorphological and immuno histochemical study of 12 cases. Diagn cytopathol 2001; 25: 343-50.

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