Pathology and diagnostic criteria of gastrointestinal stromal tumors (GISTs): a review

Miettinen, Markku; Majidi, Mourad; Lasota, Jerzy

doi:10.1016/s0959-8049(02)80602-5

Cited by 460 publications

(411 citation statements)

References 94 publications

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“…It was histologically identified as cellular spindle cell tumor and characteristically expressed c-kit and CD34, which were consistent with GIST, uncommitted type. Since the mitotic counts exceeded 5 per 50 HPF, and the subtype was uncommitted type, this tumor was thought to be malignant, although the size was smaller than 5 cm (18). The existence of HCCand adrenal adenomawas strongly suggested by clinical and radiological examinations, though it was not confirmed histopathologically.…”

Section: Discussionmentioning

confidence: 99%

Segmental Mediolytic Arteriopathy Involving Celiac to Splenic and Left Renal Arteries

et al. 2003

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Section: Discussionmentioning

confidence: 99%

Segmental Mediolytic Arteriopathy Involving Celiac to Splenic and Left Renal Arteries

et al. 2003

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“…GISTs are thought to originate from the intestinal cell of Cajal and function as intestinal pacemaker cells that regulate intestinal motility (1,8,15,29,36) . Historically GIST was misclassified as leiomyomas or leyomiossarcomas.…”

Section: Introductionmentioning

confidence: 99%

“…Subsequently, it has been determined that GISTs has particular immunophenotypical markers. The most notable one was is KIT (CD117), a tyrosine kinase inhibitor that is present in almost 95% of this tumors (15,29,33) . KIT is a transmembrane protein that stimulate the cell proliferation and inhibit the apoptosis.…”

Section: Introductionmentioning

confidence: 99%

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Ki67 and p53 in gastrointestinal stromal tumors - GIST

Neves¹,

Oshima²,

Neto³

et al. 2009

Arq. Gastroenterol.

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-Context -Gastrointestinal stromal tumor (GIST) is the most common mesenchymal tumor. Cellular proliferation and apoptosis is gaining importance for predicting prognosis in several cancers. Objective -To investigate the Ki67 and p53 immunostaining in GISTs. Methods -Specimens from 40 patients with GIST were assessed for immunohistochemical expression of Ki67 and p53. The tumors were divided according the risk of recurrence in two groups: I with high or intermediate risk and; II with low or very low risk. Results -Among the 40 patients, 21 were men, the mean age was 56 years, 16 occurred in the small intestine and 13 in the stomach, 5 in the retroperitonium, 4 in the colon or rectum and 2 in the mesenterium. Thirty two tumors were from group I and 8 from group II. Half of the patients developed recurrence, being 90% of the group I (P = 0.114). The tumor Ki67 labelling index ranged from 0.02 to 0.35 (mean level 0.12). This index was marginally higher in the group I patients with recurrence (P = 0.09) compared to the patients of the same group without recurrence. p53 staining was expressed in 65% of the GISTs. A higher frequency of p53 and Ki67 had been found in the group I tumors when compared to the other group (P = 0.022; OR = 8.00 -IC 95%: 1.32-48.65). Conclusion -The most common site was the small intestine and 80% had a malignant potential justifying the high recurrence observed. No significant correlation was found between p53 and overall outcome of the patients. In group I patients, the evaluation Ki67LI may be a marker of prognosis. The positivity of both markers is higher among the patients with worst prognosis than in the others. HEADINGS -Gastrointestinal stromal tumors. Ki-67 antigen. Tumor suppressor protein p53.

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“…They consist of gastrointestinal stromal tumor (GIST), leiomyoma or leiomyosarcoma, and schwannoma [1,2]. Gastric schwannoma contributes to 0.2 % of all gastric tumors overall, 6.3 % of gastric mesenchymal tumours and 4 % of all benign tumors of the stomach [3].…”

Section: Discussionmentioning

confidence: 99%

Gastric Schwannoma: A Case Report and Review of Literature

Sreevathsa

Pipara

2015

Indian J Surg Oncol

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Schwannomas are usually benign, slow growing tumors, that originate from any nerve that has a Schwann cell sheath. Here, we report the case of a 40 year-old female patient with an incidentally noted submucosal gastric tumor while being evaluated for cervical lymphadenopathy as a part of workup for lymphoma. She underwent sleeve resection of the stomach under suspicion of a gastrointestinal stromal tumor, but postoperative histopathological and immunohistochemical findings confirmed the diagnosis of shwannoma. Although schwannomas are mostly benign, they are often indistinguishable preoperatively from malignant tumors such as gastrointestinal stromal tumors. Therefore, resection is the treatment of choice for all such tumors.Keywords Gastric schwannoma . GIST . Immunohistochemistry . Sleeve resection Case ReportA 48 year old lady with cervical lymphadenopathy was subjected to ultrasound of the abdomen for ruling out splenomegaly as a part of work up for lymphoma. Ultrasound of the abdomen (Fig. 1) revealed a well defined lobulated hypoechoic mass lesion in the epigastric region located between the left lobe of liver and gastric wall. It was 4.2 × 4.1 cm in size. Computed tomography scan showed well defined uniformly enhancing gastric fundal wall mass, (Fig. 2) most likely to be GIST (gastrointestinal stromal tumour) with celiac axis and periportal nodal enlargement. The mass was partly exophytic and partly projecting into the lumen causing smooth indentation. The patient then underwent upper GI endoscopy which showed a sub mucosal bulge on the anterior wall of the fundus of the stomach. An endosonography was done using a linear scope which showed a large submucosal mixed echoic mass with few areas of necrosis in body of stomach mainly on greater curvature measurng 5 × 4 cm arising from muscularis propria. Two celiac nodes, hypoechoic round with uniform echotexture were also seen. FDG pet scan showed metabolically active tumor mostly representing GIST (Gastrointestinal stromal tumour) from body of the stomach (Fig. 3).A provisional diagnosis of submucosal mass, which could be most likely GIST, was made and fine needle aspiration cytology was done from both the lesion and the nodes with endosonoguidance. The FNA from gastric submucosal lesion showed features suggestive of spindle cell tumor while the celiac nodes showed reactive hyperplasia. A preoperative diagnosis of GIST arising from anterior wall of proximal stomach was made. The patient was subjected to laparoscopic examination which revealed an exophytic solid tumor measuring 6 × 7 cm arising from the anterior wall of the junction of body and fundus. The medial margin was at the lesser curvature and lateral margin was just short of greater curvature. In order to get a good tumor negative margin laparoscopy was converted to minilaparotomy and sleeve resection of the tumor was done using linear staplers. Histopathology revealed a submucosal tumor with features suggestive of spindle cell tumor (Fig. 4). IHC done showed positivity

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Pathology and diagnostic criteria of gastrointestinal stromal tumors (GISTs): a review

Cited by 460 publications

References 94 publications

Segmental Mediolytic Arteriopathy Involving Celiac to Splenic and Left Renal Arteries

Segmental Mediolytic Arteriopathy Involving Celiac to Splenic and Left Renal Arteries

Ki67 and p53 in gastrointestinal stromal tumors - GIST

Gastric Schwannoma: A Case Report and Review of Literature

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