Giant leiomyosarcoma of the remnant stomach: report of a case

The left inferior phrenic artery arising from left hepatic artery or left gastric artery: radiological and anatomical correlation in clinical cases and cadaver dissection

BACKGROUND

The purpose of this study is to assess angiographic and CT appearance of left inferior phrenic artery (LIPA) arising from left hepatic or left gastric artery and to recognize its specific anatomical location with the help of cadaver dissection.

METHODS

We retrospectively reviewed 761 abdominal angiographies and found 13 patients (1.7%) with LIPA arising from left hepatic or left gastric artery. We classified those origins and assessed radiological features. We also presented a cadaver dissection to identify anatomical location of LIPA arising from left hepatic artery.

RESULTS

The origin of the LIPA was classified as follows: (a) left hepatic artery: four, (b) accessory left gastric artery: one, (c) accessory left hepatic artery: three, and (d) left gastric artery: five patients. The proximal portion was located in gastrohepatic ligament and its distal portion was located in front of esophageal hiatus. In a cadaver dissection, the proximal portion ascends along ligamentum venosum and distal portion courses along superior aspect of left hemi diaphragm in front of esophagus.

CONCLUSION

The LIPA rarely arises from left hepatic or left gastric artery. The proximal portion was located in gastrohepatic ligament and the distal portion runs in front of the esophageal hiatus.

Induction of gastric GIST in rat and establishment of GIST cell line

Continuous administration of the direct-reacting carcinogen N-methyl-N'-nitro-N-nitrosoguanidine reportedly produces not only adenocarcinoma in rats, but also mesenchymal tumors. A large number of tumors diagnosed as gastrointestinal smooth muscle tumors actually represent gastrointestinal stromal tumors (GISTs) in human cases. We have induced mesenchymal tumors by duodenal reflux in rats. To clarify the differentiation of these mesenchymal tumors, immunohistochemical investigations were undertaken. In addition, the first culture model of GIST-DR derived from GIST induced by duodenal reflux was established. GIST-DR cells, both in vitro and in vivo, were strongly immunopositive for both KIT and CD34, and STI571 (Imatinib mesylate) blocked the proliferation of this cell line. The present results suggest that duodenal reflux plays a role in the histogenesis of GIST.