Histomorphological spectrum of gastrointestinal stromal tumors – An institutional experience in a series of seven cases

Abstract

Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the abdominal area. They can involve any portion of GI tract, omentum, mesentery, retroperitoneum, and other sites. The tumor is seen to be arising from interstitial cell of Cajal, the pacemaker cells of the GI muscularis propria. About 60% of GISTs occur in stomach. More than 95% of GISTs are positive for immunohistochemical marker Crohn’s disease (CD) CD117. Still in 5% of cases, CD117 expression is not found. Although, in these cases, staining with discovered on GIST-1 (DOG1, also known as ANO1) can be helpful in confirming the diagnosis of GIST histomorphological diagnosis remains the gold standard diagnostic modality with CD 117 positivity leading to more confirmation. Tumor size and mitotic count remain the main factors in the risk categorization of tumors. Furthermore, every spindle cell lesion should undergo CD117 immunohistochemistry markers as an initial workup.

Clinicopathological and Immunohistochemical Characterization of Gastrointestinal Stromal Tumour at Four Tertiary Health Centers in Nigeria Using CD117, DOG1, and Human Epidermal Growth Factor Receptor-2 Biomarkers

“…Overall, it can be seen that the spindle cell variant is the most commonly diagnosed histology type of GISTs in this study which is concordant with reviews from both within and other parts of the world. [ 12 , 13 , 14 , 15 , 16 , 17 , 23 , 24 , 25 , 26 , 27 ] The stomach was the most often affected region for the majority of our patients with a spindle cell histopathological type. In addition, analyses of numerous studies conducted in Nigeria and other nations around the globe have revealed that the stomach is the most typical location for GIST tumors.…”

“…[ 12 , 13 , 14 , 15 , 16 , 17 , 23 ] Similar to this, different percentages of GIST tumors have been recorded in various parts of the world, with the lowest number being 39 instances and the highest number coming from a systematic evaluation of 13,550 cases from 19 different nations. [ 1 , 25 , 26 , 27 , 28 , 29 ] The vast variety of cases recorded in different parts of the world may be related to the various researchers’ selection criteria and the tumor's demographic characteristics. Overall, it can be seen that the spindle cell variant is the most commonly diagnosed histology type of GISTs in this study which is concordant with reviews from both within and other parts of the world.…”

“…Both domestic and foreign authors back up this position. [ 12 , 13 , 14 , 15 , 16 , 17 , 23 , 24 , 25 , 26 , 27 , 28 ] In-depth research has been done on CD117's significance in the diagnosis of GIST tumors, and writers have confirmed it in relation to elucidating the mesenchymal tumor in the gastrointestinal tumor and other sites. Recently, it was found that DOG1, which is extensively expressed in GIST regardless of mutation, exists.…”

Immunohistochemical features of gastrointestinal stromal tumors and their role for differential diagnosis and prognosis

“…GISTs can share 2 most common histological patterns: spindle cell morphology and epithelioid type. Nowadays the diagnosis GIST is not be full without immunohistochemical (IHC) testing with CD117 and/or DOG-1 [3,4]. The spindled GISTs should be differentiated from leiomyomas and schwannomas.…”