Patient went on to have a biopsy. 

MICROSCOPIC DESCRIPTION

The sections show fragments of a tumour comprising spindle cells with  plump, frequently cigar-shaped, nuclei, arranged in sweeping fascicles.  There is moderate nuclear pleomorphism but only 1 mitosis per 50 high power fields.  There are areas of haemorrhage within the tissue fragments (which may represent surgical artifact) and one fragment shows a single small focus of necrosis.  The lesion contains a light, diffuse infiltrate of lymphocytes and plasma cells and in some areas there are a few neutrophils. Immunoperoxidase stains show that the tumour cells are positive for smooth muscle actin and negative for S-100 and c-Kit +ve. 

FINAL DIAGNOSIS

Gastrointestinal stromal tumour of uncertain malignant potential showing smooth muscle differentiation.  

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