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Spindle cell GIST- differentIal diagnosis

Ryuta Iwamoto, Tatsuki R Kataoka, Ayako Furuhata, Kazuo Ono, Seiichi Hirota, Kenji Kawada, Yoshiharu Sakai, Hironori Haga
BACKGROUND: We present a case of perivascular epithelioid cell tumor (PEComa), which clinically and histologically mimics a gastrointestinal stromal tumor (GIST). CASE PRESENTATION: A 42-year-old woman was found to have a mass in the left flank during her annual medical checkup. Computed tomography examination revealed a submucosal tumor of the descending colon. Surgeons and radiologists suspected that the lesion was a GIST, and left hemicolectomy was performed without biopsy...
November 14, 2016: World Journal of Surgical Oncology
Edgar Vargas Flores, Francisco Bevia Pérez, Pablo Ramirez Mendoza, José Arturo Velázquez García, Oscar Alejandro Ortega Román
INTRODUCTION: Mesenchymal tumors of the gastrointestinal tract are a group spindle cell tumors which include gastrointestinal stromal tumors, leiomyomas, leiomyosarcomas and schwannomas (Nishida and Hirota, 2000). Schwannomas generally present as a slow and asymptomatic growing mass in the gastrointestinal tract typically arising in the gastric submucosa accounting for up to 0.2% of gastric tumors (Melvin and Wilkinson, 1993; Sarlomo-Rikala M, Miettinen, 1995). TREATMENT: with negative surgical margin resection (as approached in this case) is considered the standard treatment...
October 20, 2016: International Journal of Surgery Case Reports
Maureen O'Sullivan
Since its foundation by remarkably talented and insightful individuals, prominently including Pepper Dehner, pediatric soft tissue tumor pathology has developed at an immense rate. The morphologic classification of tumoral entities has extensively been corroborated, but has also evolved with refinement or realignment of these classifications, through accruing molecular data, with many derivative ancillary diagnostic assays now already well-established. Tumors of unclear histogenesis, classically morphologically undifferentiated, are prominent amongst pediatric sarcomas, however, the classes of undifferentiated round- or spindle-cell-tumors-not-otherwise-specified are being dismantled gradually with the identification of their molecular underpinnings...
November 2016: Seminars in Diagnostic Pathology
Ke-Kang Sun, Song Xu, Jinzhen Chen, Gang Liu, Xiaojun Shen, Xiaoyang Wu
Gastrointestinal stromal tumors (GISTs) are mesenchymal neoplasms that arise in the gastrointestinal tract, accounting for ~1% of gastric malignancies. The present study reports the case of a GIST of the stomach in a 75-year-old man who presented with abdominal distension and anorexia for 1 month. Gastroscopy was unremarkable. Ultrasound and computed tomography (CT) scans showed a giant intraabdominal cystic lesion of unknown origin. The lesion was initially believed to be a duplication cyst, a pancreatic pseudocyst or a liver cyst in the pre-operative diagnosis...
October 2016: Oncology Letters
So Jung Lee, Chung Su Hwang, Ahrong Kim, Kyungbin Kim, Kyung Un Choi
Leiomyomas and schwannomas of the gastrointestinal tract (GIT) are mainly comprised of spindle-shaped tumor cells and should always be differentiated from gastrointestinal stromal tumors (GISTs). Mast/stem cell growth factor receptor Kit (KIT) and discovered on GIST-1 (DOG1) are well-known diagnostic markers for the detection of a GIST by immunohistochemical staining. The aim of the present study was to assess the prevalence and significance of spindle cell tumors of the GIT with KIT- or DOG1-positive spindle-shaped cells, presumed to be interstitial cells of Cajal (ICCs), other than GISTs...
August 2016: Oncology Letters
Anna Caterina Milanetto, Valbona Liço, Stella Blandamura, Claudio Pasquali
BACKGROUND: First described by Ross in 1951, primary pancreatic leiomyosarcoma is a rare mesenchymal tumour of the pancreas, with nonspecific clinical and radiological features and a poor prognosis, if unresectable. CASE REPORT: A 60-year-old woman presented with abdominal pain. Magnetic resonance imaging (MRI) and computed tomography (CT) scan detected a dishomogeneous egg-shaped 8-cm mass, arising from the pancreatic head, with duodenal compression, without dilation of the Wirsung duct...
December 2015: Surgical Case Reports
Jae Min Chun, Kyoung Hoon Lim
INTRODUCTION: Gastrointestinal stromal tumors (GISTs) of the appendix are extremely rare. To date, only 15 cases have been reported in the English literature. Here, we present a new case of an appendiceal GIST with appendicitis. PRESENTATION OF CASE: A 68-year-old man who complained of right lower abdominal tenderness underwent surgery for a cystic mass mimicking Meckel's diverticulum. Laparoscopy revealed a mass protruding from the proximal appendix with distal appendicitis...
2016: International Journal of Surgery Case Reports
Ahmad Monabati, Moeinadin Safavi, Freidoon Solhjoo
INTRODUCTION: Extragastrointestinal stromal tumors (EGIST) are rarer counterparts of gastrointestinal stromal tumors (GIST) in omentum, mesentery, and retroperitoneum. CASE REPORT: Hereby, authors present a 47-year-old man with abdominal mass whose abdominal CT scan revealed a large septated cystic mass measuring 16 cm in largest diameter. The mass was aspirated and resected by laparotomy. Pathologic examination exhibited a mesenchymal spindle cell neoplasm which was immunohistochemically reactive for CD117 and SMA...
June 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Yuki Ozato, Ryohei Kawabata, Masato Yoshikawa, Chizu Kameda, Chikato Koga, Masahiro Murakami, Masaki Hirota, Shingo Noura, Masakazu Ikenaga, Junzo Shimizu, Hideaki Miwa, Junichi Hasegawa
The patient, a 76-year-old man, presented to his local doctor's clinic with complaints of fatigue and lightheadedness. Because blood test results indicated anemia, he was referred to our hospital. Upper gastrointestinal endoscopy indicated a type 2 tumor of approximately 5 cm at the top of the gastric corpus. Biopsy results indicated that the lesion was a poorly differentiated adenocarcinoma. Computed tomography showed multiple liver metastases and the patient was diagnosed with stage Ⅳ gastric cancer. After a blood transfusion, chemotherapy with S-1 was started...
November 2015: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Yong-Peng Wang, Y I Li, Chun Song
The aim of the present study was to assess the clinicopathological features and prognostic factors of primary small gastrointestinal stromal tumors (GISTs) outside the stomach. The clinical data, clinicopathological features and prognostic factors of 20 patients with a pathologically-confirmed diagnosis of non-gastric GIST that were treated at Liaoning Cancer Hospital & Institute between July 2006 and December 2013 were retrospectively analyzed. In total, 15 patients were male and 5 were female, with a median age of 58 years (range, 44-82 years)...
November 2015: Oncology Letters
Fausto Famà, Giovanni Scibilia, Dario Lo Presti, Jessica Palella, Olivier Saint-Marc, Arnaud Piquard, Maria Gioffrè-Florio
Gastrointestinal stromal tumours are rare mesenchymal neoplasms, accounting less than 3% of all the gastrointestinal tumours, that may arise in all portions of the gastrointestinal tract but more frequently they involve stomach and small bowel. Generally are asymptomatic or slight symptomatic, although they may also cause acute clinical conditions. Histologically are characterised by a meshwork of spindle-like cells mixed with fibro-hyaline stroma. The immunohistochemical assessment, marked for a strong immunopositivity for CD117 antibodies, allows the differential diagnosis with others muscular, nervous and fibroblastic tumours...
July 2015: Annali Italiani di Chirurgia
Yanyang Chen, Fen Wang, Anjia Han
Fat-forming solitary fibrous tumor (SFT) is a rare soft tissue tumor. Herein, we reported a 30-year-old woman was found to have a solid mass measuring 60×45 mm in the right kidney on an abdominal computed tomography scan. The tumor was well-circumscribed and composed of cellular nodules with the classic SFT admixed with clusters and lobules of mature adipocytes. Immunohistochemistry staining showed that the tumor cells were diffusely and strongly positive for CD34 and Bcl-2, focally and weakly positive for CD99 and EMA...
2015: International Journal of Clinical and Experimental Pathology
Khin Thway, Wen Ng, Charlotte Benson, John Chapman, Cyril Fisher
DOG1 is a highly sensitive marker for gastrointestinal stromal tumor (GIST) and is in the routine diagnostic antibody repertoire of many surgical pathology laboratories. Moreover, GIST is well recognized by both pathologists and clinicians in the differential diagnosis of intra-abdominal and pelvic neoplasms. Low-grade fibromyxoid sarcoma (LGFMS) is, however, much less frequently anticipated, particularly when occurring at unusual sites, because of its rarity and bland histology, particularly on core biopsy...
September 2015: International Journal of Surgical Pathology
Hiroshi Okano, Tomomasa Tochio, Daisuke Suga, Hiroaki Kumazawa, Yoshiaki Isono, Hiroki Tanaka, Shimpei Matsusaki, Tomohiro Sase, Tomonori Saito, Katsumi Mukai, Akira Nishimura, Youichirou Baba, Tetsuya Murata
A 79-year-old male was referred to the hospital with a history of abdominal discomfort. Abdominal computed tomography revealed a cystic tumor with irregular wall thickness, approximately 50 mm in diameter, along the lesser curvature of the gastric body. Magnetic resonance imaging visualized the mass as signal-hyperintense on T2-weighted imaging. Esophagogastroduodenoscopy showed a submucosal tumor with normal mucosa. Surgery was performed and the 60 × 50 × 50 mm mass was resected. The resected tumor comprised cystic and solid regions; the cystic region was filled by light bloody serous fluid...
August 2015: Clinical Journal of Gastroenterology
Joshua Hobbs, James Sutherland-Smith, Dominique Penninck, Samuel Jennings, Lisa Barber, Bruce Barton
Canine gastrointestinal stromal tumors (GISTs) are a recent subtype of gastrointestinal spindle cell tumor recognized with the increasing use of immunohistochemistry. To our knowledge, no imaging features have been described in immunostochemically confirmed canine GISTs. The objective of this retrospective, cross-sectional study was to describe ultrasonographic features of canine GISTs compared with other spindle cell tumors. Thirty-seven dogs with an ultrasonographically visible gastrointestinal mass and a histopathologic diagnosis of spindle cell neoplasia were examined...
July 2015: Veterinary Radiology & Ultrasound
Yoshihiko Tashiro, Fumio Matsumoto, Keiko Iwama, Ai Shimazu, Sei Matsumori, Shigeo Nohara, Hiroyoshi Miura, Masahiko Takei, Koji Namekata, Masaru Takase, Motoi Okada, Hidenori Tsumura
Schwannomas of the colon are rare and difficult to diagnose preoperatively. We report a case of schwannoma of the ascending colon that was resected laparoscopically. A 64-year-old woman was referred to our hospital by her local clinic for further evaluation and management of a submucosal tumor of the ascending colon. A definitive preoperative diagnosis could not be reached despite examinations. Gastrointestinal stromal tumor, leiomyoma and lymphoma were the differential diagnoses. We performed a laparoscopic right hemicolectomy with D2 lymph node dissection...
January 2015: Case Reports in Gastroenterology
Jung-Sik Huh, Kyung Kgi Park, Young Joo Kim, Sung Dae Kim
Gastrointestinal stromal tumors (GISTs) are an unusual and heterogeneous group of spindle cell tumors that can also appear on the exterior of the gastrointestinal tract (extra-GISTs). Despite the fact that extra-GISTs or large rectal GISTs can lead to the clinical impression of a prostatic mass, these tumors are, in general, excluded in the differential diagnosis of spindle cell tumors observed on prostate needle biopsy. Here, we present, in detail, a case of an extra-GIST identified on prostatic biopsy; the tumor was previously believed to be a primary prostatic stromal sarcoma in the differential diagnosis...
December 2014: World Journal of Men's Health
Lysandra Voltaggio, Elizabeth A Montgomery
Interpretation of gastrointestinal tract mesenchymal lesions is simplified merely by knowing in which anatomic layer they are usually found. For example, Kaposi sarcoma is detected on mucosal biopsies, whereas inflammatory fibroid polyp is nearly always in the submucosa. Gastrointestinal stromal tumors (GISTs) are generally centered in the muscularis propria. Schwannomas are essentially always in the muscularis propria. Mesenteric lesions are usually found in the small bowel mesentery. Knowledge of the favored layer is even most important in interpreting colon biopsies, as many mesenschymal polyps are encountered in the colon...
January 2015: Modern Pathology: An Official Journal of the United States and Canadian Academy of Pathology, Inc
Ju Xiang Ye, Yan Liu, Yun Qin, Xiao Long Ma, Hao Hao Zhong, Yan Zhang, Xue Ying Shi
The presence of CD117 positive cells in esophageal leiomyoma may lead to a misdiagnosis of GIST. We reviewed 46 esophageal tumors which were smooth muscle tumors or GIST. Based on morphology, immunohistochemistry and mutation analysis, there were 44 (95.6%) leiomyomas, 1 (2.2%) leiomyosarcoma, and 1 (2.2%) GIST. Variable numbers of CD117 positive cells were seen in all leiomyomas. Tryptase immunostaining identified mast cells in 93.2% (41/44) of leiomyomas, and the number of mast cells per tumor decreased significantly from tumors of the upper esophagus to the esophageal-gastric junction (p<0...
May 2015: Histology and Histopathology
Abbey J Winant, Marc J Gollub, Jinru Shia, Christina Antonescu, Manjit S Bains, Marc S Levine
OBJECTIVE: The purpose of this article is to describe the imaging and clinicopathologic characteristics of esophageal gastrointestinal stromal tumors (GISTs) and to emphasize the features that differentiate esophageal GISTs from esophageal leiomyomas. MATERIALS AND METHODS: A pathology database search identified all surgically resected or biopsied esophageal GISTs, esophageal leiomyomas, and esophageal leiomyosarcomas from 1994 to 2012. Esophageal GISTs were included only if imaging studies (including CT, fluoroscopic, or (18)F-FDG PET/CT scans) and clinical data were available...
August 2014: AJR. American Journal of Roentgenology
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