Cytomorphology of gastrointestinal stromal tumor: Diagnostic role of aspiration cytology, core biopsy, and immunochemistry

Abstract

Gastrointestinal stromal tumors (GISTs) comprise a heterogeneous group of neoplasms of the gastrointestinal tract previously referred to as leiomyomas, leiomyosarcomas, or schwannomas. GISTs derive from the interstitial cell of Cajal and, in addition to variable expression of smooth muscle and neural markers, they characteristically express CD34 and CD117. To our knowledge, the cytologic appearance of gastric neoplasms designated as GISTs has never been reported. We illustrate the fine‐needle aspiration (FNA) cytology findings of a gastric stromal tumor having spindle cells with delicate cytoplasm and prominent nuclear palisading. Consistent core biopsy and immunochemistry findings further supported the diagnosis of GIST. Pathologic evaluation of the resected tumor confirmed the cytologic diagnosis. In the appropriate clinical and radiologic setting, a confident diagnosis of GIST can be established by FNA cytology and core biopsy. The roles of immunochemical stains and other ancillary techniques in reaching the correct diagnosis are addressed. Diagn. Cytopathol. 2000; 23:156–160. © 2000 Wiley‐Liss, Inc.

Fine Needle Aspiration Cytology (FNAC) of Gastrointestinal Stromal Tumor: An Emphasis on Diagnostic Role of FNAC, Cell Block, and Immunohistochemistry

“…Li et al (17) also found that mitoses in the resected malignant GISTs were seldom seen in FNAC smear. Besides, in the present and previous (14,15,19) studies malignant GISTs had no significant pleomorphism in the cytologic smears. The assessment of malignant potential is difficult based on cytomorphologic features alone and predictions about potential aggressiveness should be best reserved for gross and histologic examination of the resected specimen.…”

“…Although there have been only a few case reports and series of cases published (14)(15)(16)(17)(18)(19), every diagnosis was not supported by c-kit immunostain (18,19), cytohistologic correlation (16), and histologic diagnoses (16,18). Most of the cases were not correlated with follow-up data (14,17,18). Until recently, GIST treatment consisted of a surgical resection followed by surveillance for metastatic disease.…”

Cytologic diagnosis of gastrointestinal stromal tumor with emphasis on the differential diagnosis with leiomyosarcoma

“…4,14 Despite these difficulties, it is clinically important to make the distinction, 4 both because of differences in metastatic pattern and prognosis 15 and because of the recent development of tyrosine kinase inhibitors, which have the potential to target the specific molecular defect in GIST. 3,16,17 Because this differential diagnosis is challenging and important, and because of what we believe to be the paucity of prior reports, 18,19 we describe herein our experience with the cytologic diagnosis of GIST.…”

Stomach Preserving Surgery in Large Exophytic Gastointestinal Stromal Tumour

“…GISTs are now defined as cellular, spindle cell, epitheloid or occasional pleomorphic mesencymal tumours of the GIT expressing CD34 and CD117(c-kit) a product of c kit proto-oncogene (7) . Clinical presentation varies from an incidental radiological finding when a patient is investigated for other symptoms to cases of intestinal obstruction, upper or lower GI bleeding or melena, and also as an emergent idiopathic spontaneous intraabdominal hemorrhage.…”