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GIST- differential diagnosis of epithelioid and spindle cell types

Nick Baniak, Lawrence Lee, Chen Zhou, Sean Young, Darryl Yu
Gastrointestinal stromal tumors (GIST) are the most common mesenchymal neoplasms of the digestive tract. They are relatively rare neoplasms compared with gastrointestinal carcinomas and usually can readily be differentiated from carcinomas based on the morphology of the neoplastic cells that are typically spindled (70%), pure epithelioid, or mixed type. GISTs in general lack expression of cytokeratin and exhibit immunoreactivity toward CD117, CD34, or DOG1. GISTs can demonstrate a pure epithelioid morphology that can appear similar histologically to a carcinoma...
March 30, 2017: Applied Immunohistochemistry & Molecular Morphology: AIMM
Guhyun Kang, Young Soo Park, Eun-Sun Jung, Mee Joo, Mi Seon Kang, Soomin Ahn, Gu Hyum Kang, Kyoung-Mee Kim
Studies on gastrointestinal stromal tumors (GISTs) in young patients are limited due to their rarity, and none have been conducted in Asian populations. GISTs from patients under the age of 30 were retrospectively reviewed and were analyzed for clinicopathologic features, immunohistochemistry for SDHB (succinate dehydrogenase subunit B), and mutations for exon 9, 11, 13, and 17 of KIT gene and exon 12, 14, and 18 of PDGFRA gene. We found two pediatric (<18 years old) and 20 young adult (18-30 years old) GIST cases...
October 2013: APMIS: Acta Pathologica, Microbiologica, et Immunologica Scandinavica
Ondrej Daum, Tomas Vanecek, Zdenek Benes, Michal Michal
Gastrointestinal stromal tumor (GIST) is the most frequent mesenchymal tumor of the alimentary tract, presently being defined as a tumor composed of spindle and/or epithelioid cells presumably differentiating towards interstitial cells of Cajal. The most frequent location of gastrointestinal stromal tumor is the stomach, followed by other sites of gastrointestinal tract. Occasional sites of occurrence are mesenterium, omentum, retroperitoneum, gall bladder, urinary bladder, pancreas, prostate and the vagina...
November 2007: Expert Opinion on Medical Diagnostics
Markku Miettinen, Zeng-Feng Wang, Jerzy Lasota
Gastrointestinal stromal tumors (GISTs), KIT or platelet derived growth factor receptor alpha (PDGFRA) signaling driven mesenchymal tumors of the gastrointestinal (GI)-tract and abdomen, require a precise diagnosis so that the patients may benefit from the newly introduced tyrosine kinase inhibitor drugs. The limitations of the current main tools, KIT immunohistochemistry and KIT/PDGFRA mutation analysis, include lack of KIT expression and mutations in some GISTs. In this study we examined 1168 GISTs of different sites and histologic subtypes, and 672 other tumors and normal tissues for discovered on GIST-1 (DOG1) clone K9, a newly introduced immunohistochemical marker, a chloride channel protein...
September 2009: American Journal of Surgical Pathology
Song Zheng, Li-Rong Chen, Hai-Jun Wang, Shui-Zhen Chen
BACKGROUND/AIMS: To investigate the effect of the expression and mutation of c-kit and PDGFR-alpha gene and its association with clinical pathology and prognosis of gastrointestinal stromal tumor (GIST). METHODOLOGY: Paraffin-embedded tissues from 119 GISTs were analyzed for CD 117 and PDGFR-alpha expression by immunohistochemical method. Fifty GISTs were measured for the presence of c-kit exons 9, 11 and 13 mutations and PDGFR-alpha exons 12, 18 mutations. RESULTS: Of 119 GISTs, 104 (87...
December 2007: Hepato-gastroenterology
Hongbo Yu, Joanna A Gibson, Geraldine S Pinkus, Jason L Hornick
Podoplanin, recognized by monoclonal antibody D2-40, may be a useful marker for follicular dendritic cell (FDC) tumors. Paraffin sections of 125 dendritic cell, histiocytic, and spindle cell lesions were studied, including 11 FDC tumors, 5 interdigitating dendritic cell tumors, 10 histiocytic sarcomas, 5 Langerhans cell histiocytosis, 5 sinus histiocytosis with massive lymphadenopathy, 5 inflammatory pseudotumors of lymph node or spleen, 9 nodal Kaposi sarcomas, 6 inflammatory myofibroblastic tumors (IMTs), 29 gastrointestinal stromal tumors (GISTs), and 10 cases each of malignant peripheral nerve sheath tumor, leiomyosarcoma, monophasic synovial sarcoma (SS), and solitary fibrous tumor...
November 2007: American Journal of Clinical Pathology
A Agaimy, P H Wünsch
BACKGROUND: The distribution and reactivity pattern of neural cell adhesion molecule (NCAM/CD56) in gastrointestinal stromal tumours (GISTs) and their mesenchymal mimics have not been investigated in the KIT era. METHODS: 275 histologically and immunohistochemically well characterised primary and metastatic intra-abdominal mesenchymal lesions were analysed by conventional immunohistochemistry, with emphasis on GIST and GI smooth muscle neoplasms. RESULTS: CD56 expression was seen in 18/21 (86%), 4/5 (80%), 26/34 (76%), and 32/168 (19%) of primary GI leiomyomas, schwannomas, leiomyosarcomas, and GISTs, respectively...
April 2008: Journal of Clinical Pathology
Zhi-Qiang Wang, Shan Wang, Ying-Jiang Ye, Yi-Long Kang, Kun-Kun Sun, Hong-Fang Zheng
OBJECTIVE: To study the clinical pathologic and immunohistochemical features of gastrointestinal mesenchymal tumors (GIMTs), and to investigate the value of molecular markers in GIMTs clinical differentiation diagnosis. METHODS: The clinical and pathological data of 210 cases of GIMTs, collected from Jan. 1987 to Dec. 2005 in our hospital, were investigated retrospectively. GIMTs were rediagnosed by using standard immunostaining technique in paraffin-embedded tissue...
January 2007: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Isabel Alvarado-Cabrero, Gonzálo Vázquez, Francisca I Sierra Santiesteban, Dulce Ma Hernández-Hernández, Angel Zavala Pompa
It is important to distinguish gastrointestinal (GI) stromal tumors (GISTs) from other GI mesenchymal tumors (GIMTs) because of the availability of molecular-targeted therapy for GISTs. The aim of the study was to reclassify GIMTs and to determine the clinicopathologic features of GISTs in Mexico. Cases of GIMT identified from the database of 3 large diagnostic centers in Mexico between 1995 and 2004 were reclassified according to current criteria. Hematoxylin and eosin-stained sections and clinical histories were reviewed, and immunohistochemistry was performed using anti-CD117, CD34, smooth muscle actin, and S-100 protein...
February 2007: Annals of Diagnostic Pathology
Markku Miettinen, Jerzy Lasota
CONTEXT: Gastrointestinal stromal tumors (GISTs) are specific, generally Kit (CD117)-positive, mesenchymal tumors of the gastrointestinal tract encompassing a majority of tumors previously considered gastrointestinal smooth muscle tumors. They are believed to originate from interstitial cells of Cajal or related stem cells. OBJECTIVE: To review current clinicopathologically relevant information on GIST. DATA SOURCES: Literature in Medline and authors' own experience...
October 2006: Archives of Pathology & Laboratory Medicine
P Pauwels, M Debiec-Rychter, M Stul, I De Wever, A T Van Oosterom, R Sciot
AIMS: The diagnosis of gastrointesinal stromal tumours (GISTs) is widely based on morphological features and KIT (CD117) immunoreactivity. Most patients with advanced GISTs show a major clinical response after treatment with imatinib mesylate. The histopathological features of GISTs in patients on prolonged imatinib treatment have, thus far, not been addressed in detail. In this report, we present three patients with metastatic GISTs, who received more than 1 year of therapy with imatinib, and whose tumours changed their morphological and immunohistochemical characteristics during continued treatment with the drug...
July 2005: Histopathology
Qi-chang Yang, Xiao-hua Ji, Yi Shen, Fang Han, Xiao-juan Zhang, Hong-bin Liu
OBJECTIVE: To explore a simplified and reproducible approach for the diagnosis and morphologic prognostication of gastrointestinal stromal tumor (GIST). METHODS: Eighty-five cases of gastrointestinal mesenchymal tumors including 74 cases of GIST, 8 esophageal smooth muscle tumor, 1 rectal leiomyosarcoma, 1 Schwannoma, and 1 malignant fibrous histiocytoma were studied by histological evaluation along with an immunohistochemistry panel including vimentin, CD117 (c-kit), CD34, SMA, desmin and S-100...
January 2005: Zhonghua Bing Li Xue za Zhi Chinese Journal of Pathology
Ying-yong Hou, Meng-hong Sun, Yong-kun Wei, Yun-shan Tan, Xiao-yu Lu, Jian Wang, Xiong-zeng Zhu, Ai-hua Zheng
OBJECTIVE: To explore the clinicopathological, immunohistochemical and molecular genetic features of intra-abdomen extra-gastrointestinal stromal tumors (EGISTs) and their differential diagnosis. METHODS: Nine cases of EGISTs from the abdominal cavity or retroperitoneum which were previously diagnosed as leiomyoma, leiomyoblastoma, or leiomyosarcoma etc. by a panel of antibodies such as CD117, CD34, alpha-SMA, MSA, desmin, S-100, and PGP9.5 from which five cases were detected for c-kit gene mutation...
October 2003: Zhonghua Bing Li Xue za Zhi Chinese Journal of Pathology
Ping Liu, Jia Na, Ying Wang, Qun He, Ying Zhang, Xiuying Tang, Wanzhong Zou
OBJECTIVE: To investigate the morphological features, immunohistochemical speciality of the gastrointestinal stromal tumors (GISTs), and its histogenesis as well. METHODS: The morphologic characteristics of GISTs were studied in 65 cases using light microscopy and 17 cases by electron microscopy. The expression of c-kit (CD117), CD34, vimentin, SMA, actin, desmin, S-100 and MBP were detected in all the cases with EnVision trade mark staining. RESULTS: Among 65 cases of GISTs, 46 were spindle cell type, 6 epithelioid cell type and 13 mixture type, equivalent to 85...
June 2002: Zhonghua Bing Li Xue za Zhi Chinese Journal of Pathology
Maarit Sarlomo-Rikala, Tohru Tsujimura, Urban Lendahl, Markku Miettinen
The KIT-positive specific gastrointestinal stromal tumors (GISTs), leiomyomas, and schwannomas are the three most common types of primary mesenchymal tumors of the gastrointestinal (GI) tract. The intermediate filaments are abundant cytoskeletal proteins commonly used as cell differentiation markers in diagnostic immunohistochemistry. Their patterns have not been fully characterized in GI mesenchymal tumors, and could offer differential diagnostically useful parameters. Very recently, nestin, a class VI intermediate filament expressed in neuroectodermal stem cells and skeletal muscle progenitor cells, has been shown in GISTs and suggested as a marker for these tumors...
June 2002: APMIS: Acta Pathologica, Microbiologica, et Immunologica Scandinavica
Mai Gu, Phuong Thivan Nguyen, Sean Cao, Fritz Lin
BACKGROUND: The majority of glomus tumor are small, benign neoplasms that arise from modified smooth muscle cells. They usually occur in the dermis or subcutis of the extremities. However, rare cases have been reported in the visceral locations, most often in the stomach. CASE: A 32-year-old woman presented with episodes of right upper quadrant pain. She was found to have a gastric tumor that was biopsied at another hospital, where the diagnosis of gastrointestinal stromal tumor (GIST) was made...
May 2002: Acta Cytologica
Yingyong Hou, Jian Wang, Xiongzeng Zhu, Xiang Du, Menghong Sun, Aihua Zheng
OBJECTIVE: To study the morphologic and immunohistochemical features of gastrointestinal stromal tumors (GISTs) and to explore the reference parameters for malignancy. METHODS: Seventy six (76) cases of primary GISTs were distinguished from a group of gastrointestinal mesenchymal tumors by use of a panel of antibodies such as CD117, CD34 by immunohistochemical EnVision method, their biologic behaviors were analyzed by including their follow-up data. RESULTS: All patients were adults, age range 32 to 81 years (mean 54 year), male 39 cases and female 37 cases; the tumors were situated in stomach (36 cases), in small intestine (23 cases), colon (2 cases) and rectum (15 cases)...
February 2002: Zhonghua Bing Li Xue za Zhi Chinese Journal of Pathology
T J Wieczorek, W C Faquin, B P Rubin, E S Cibas
BACKGROUND: Gastrointestinal stromal tumor (GIST) has only recently been distinguished histologically and immunochemically from morphologically similar neoplasms of the abdomen. METHODS: The authors reviewed 15 cytologic cases of GIST (14 fine-needle aspiration [FNA] specimens and 1 peritoneal fluid specimen) and compared them with 23 cases of leiomyosarcoma (LMS) arising in the abdomen or pelvis (all FNAs). Immunochemistry (IC) was performed on both the cytologic and subsequent tissue specimens if sufficient specimen was available...
August 25, 2001: Cancer
S Q Li, T J O'Leary, S B Buchner, R M Przygodzki, L H Sobin, Y S Erozan, D L Rosenthal
OBJECTIVE: Gastrointestinal stromal tumors (GISTs) are uncommon mesenchymal tumors of the gastrointestinal tract. Fine needle aspiration (FNA) is one option for diagnosing GISTs before surgery. This study was designed to evaluate the clinical utility of FNA in the diagnosis of GISTs. STUDY DESIGN: FNAs from 19 GISTs originating in the stomach, small bowel and colon obtained from 1988 to 1998 were studied. Immunocytochemistry was performed on 12 cases. The GISTs were classified as benign, borderline and malignant, according to location, size, mitotic activity and clinical outcome...
January 2001: Acta Cytologica
R K Yantiss, I J Spiro, C C Compton, A E Rosenberg
Intra-abdominal fibromatosis (IAF) is an uncommon benign neoplasm that usually occurs in the mesentery or retroperitoneum and may, on occasion, mimic a gastrointestinal stromal tumor (GIST). Differentiating between these two entities is important clinically because IAF is a benign tumor whereas GISTs frequently have malignant potential. In this study, the authors identified 13 cases of IAF with prominent involvement of the bowel wall as well as 35 GISTs of the small intestine, colon, or mesentery and analyzed their clinical, gross, histologic, immunophenotypic, and ultrastructural characteristics to identify important distinguishing features...
July 2000: American Journal of Surgical Pathology
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