Gastric submucosal tumours of neurogenic origin with neuroaxonal and schwann cell elements

Abstract

Twelve cases of gastric submucosal tumours, originally diagnosed as leiomyoma and leiomyosarcoma, were investigated by staining with the neurogenic markers S-100 and neuron specific enolase (NSE). Three cases were, in addition, studied by electron microscopy. The tumours stained negatively for desmin, indicating that they were not of smooth muscle origin. All stained positively for S-100 and NSE. The ultrastructural features in the cases examined by electron microscopy were reminiscent of autonomic nerve structures normally present in the gastric wall. These included fine cytoplasmic processes of Schwann cells, wrapped with complete or incomplete basement membranes, and structures analogous to post-ganglionic neuroaxonal components. These tumours appear to represent a distinct type of gastric neoplasm originating from autonomic nerve elements in the stomach wall. They are different from previously described schwannomas or neurofibromas. In some of the tumours, identifiably neural elements are relatively a minor component, and the majority of the tumour cells are of undetermined origin. It is suggested that these cells may be poorly differentiated, lacking their antigenic determinants specific to neural differentiation.

Gastrointestinal autonomic nerve tumours and their separation from other gastrointestinal stromal tumours: an ultrastructural and immunohistochemical study of seven cases

“…In the majority of our cases the ultrastructural and immunohistochemical findings allow us the distinction between GAN and smooth muscle tumours; a source of difficulty is to differentiate between them and Schwann cell tumours. The presence of electron dense granules in dendritic prolongations indicates neuroaxonal differentiation [27]. Our cases do not display features which are considered to be hallmarks of schwannian differentiation such as continuous basal lamina, mesoaxonal structures and long-spaced collagen.…”

“…Our cases do not display features which are considered to be hallmarks of schwannian differentiation such as continuous basal lamina, mesoaxonal structures and long-spaced collagen. However, Yagigashi et al [27] describe a distinctive neurogenic tumour of the stomach composed of neuroaxonal and schwannian elements suggesting they probably arise from a combination of Schwann cells and ganglion cells. These tumours display mesoaxonal structures containing microtubules, microfilaments and small electron-dense granules (some of them considered to be lysosomes).…”

Gastrointestinal stromal tumors and leiomyosarcomas

“…Immunohistochemical studies confirmed that not only do GISTs lack features of smooth muscle cells [18][19][20], but GISTs also possess characteristics of neural cells [21,22]. Therefore, a more accurate means of identifying GIST was needed.…”

Gastrointestinal Stromal Tumors in Equids

“…As this wider spectrum has emerged, the term gastrointestinal stromal tumors (GIST) has been applied with increasing frequency to this group of differentiated and undifferentiated tumors in humans. 1,13,19,22,25,37 This term has re-*Deceased.…”