Cytological Findings of Gastrointestinal Stromal Tumor-Derived Bone Metastasis

2018 ◽  
Vol 62 (5-6) ◽  
pp. 430-435 ◽  
Author(s):  
Hiroaki Kanda ◽  
Noriyuki Furuta ◽  
Yutaka Takazawa ◽  
Reiko Furuta ◽  
Keisuke Ae ◽  
...  

Objective: Procedures for diagnosing bone tumors should be rapid and minimally invasive. Thus, cytological examinations are more useful for such purposes than histological examinations. In order to identify cytomorphological findings that could be used to diagnose bone metastasis from gastrointestinal stromal tumors (GIST), previous cases were reviewed. Study Design: Cytological samples of 7 lesions from 4 patients with GIST-derived bone metastasis, which were obtained from 2001 to 2017 at the JFCR Cancer Institute Hospital, were reviewed. Results: The metastasis of GIST to the bone was clinically suspected before the cytological and histological examinations in all cases since they all involved other metastatic lesion(s), and characteristic osteolytic lesions were detected on radiological images. Although various cell shapes were encountered, spindle cell proliferation was seen in all cytological samples. No pleomorphism was apparent. Characteristic nuclear findings were observed. All of the cases could be diagnosed as GIST-derived bone metastasis. Conclusion: GIST-derived bone metastasis can be diagnosed by examining cytological samples.

2005 ◽  
Vol 3 (3) ◽  
pp. 0-0
Author(s):  
Mindaugas Plečkaitis ◽  
Ugnius Mickys ◽  
Arvydas Rimkevičius

Mindaugas Plečkaitis1, Ugnius Mickys1, Arvydas Rimkevičius21 Valstybinis patologijos centrasBaublio g. 5, LT-08406 Vilnius2 Vilniaus universitetoEksperimentinės ir klinikinės medicinos institutas,Žygimantų g. 9, LT-01102 VilniusEl paštas: [email protected]; [email protected] Tradiciškai gastrointestininio trakto šeivinių ląstelių navikai dėl panašumo į lygiųjų raumenų navikus buvo vadinami lejomiomomis arba lejomiosarkomomis. Lygiųjų raumenų navikai su epitelioidinėmis ląstelėmis buvo vadinami lejomioblastomomis, vėliau – epitelioidinėmis lejomiomomis ar lejomiosarkomomis. Terminas "gastrointestininės stromos navikas" apėmė tiek lygiųjų raumenų, tiek nervinius, tiek nediferencijuojamus navikus. Atrasta CD117 baltymo hiperekspresija leido atskirti gastrointestininių stromos navikų (GIST) grupę, kitokią nei gastrointestininio trakto lygiųjų raumenų ir nerviniai navikai. Dauguma GIST (~95%) yra susiję su c-kit protoonkogeno mutacijomis, kurios sukelia transmembraninio augimo faktoriaus receptoriaus (CD 117 baltymo / c-kit) hiperekspresiją, sėkmingai aptinkamą imunohistochemiškai. Apžvalgoje apibendrintas šiandienis požiūris į gastrointestininės stromos navikų histogenezę, epidemiologiją, patologiją, imunofenotipą, diferencinę diagnozę, gydymą, kai kuriuos diagnostikos metodologinius aspektus ir šio naviko biologinę elgseną nusakančias schemas. Reikšminiai žodžiai: gastrointestininės stromos navikai, c-kit protoonkogenas, CD117 Gastrointestinal stromal tumors: the present attitude and diagnostics Mindaugas Plečkaitis1, Ugnius Mickys1, Arvydas Rimkevičius21 Lithuanian State Centre of Pathology,Baublio str. 5, LT-08406, Vilnius, Lithuania2 Vilnius Universitety,Institute of Experimental and Clinical Medicine,Žygimantų str. 9, LT-01102, Vilnius, LithuaniaE-mail: [email protected]; [email protected] Traditionally, spindle cell tumors of the gastrointestinal tract have been classified as leiomyoma or leiomyosarcoma because of a close morphologic resemblance to smooth muscle tumors. Tumors with epithelioid cells were designated as leiomyoblastoma and later as epithelioid leiomyoma or leiomyosarcoma. The term "gastrointestinal stromal tumor" included smooth muscle tumors, neural tumors and undiferentiated tumors. The discovery of CD117 hyperexpression gave the possibility to separate the GIST group, which is different from smooth muscle and neural tumors of gastrintestinal tract. The majority of GISTs (approximately 95%) are related to mutations of the c-kit proto-oncogene gene. These mutations result in a hyperexpression of the transmembrane growth factor receptor (CD117 protein / c-kit), which is reliably detected by immunohistochemistry. The present attitude of hystogenesis, epidemiology, pathology, immunofenotype, differential diagnosis, treatment, some methodologic aspects of diagnostics and schemes of biological behavior of gastrointestinal stromal tumors are summarized in the review. Keywords: gastrointestinal stromal tumors, c-kit proto-oncogene, CD117


2021 ◽  
pp. 10-16
Author(s):  
Yana Miroshnichenko

The aim. To clarify all most important immunohistochemical features of gastrointestinal stromal tumors with different histological patterns and analyze the role of expression of Ki-67, MMP-9, VEGF and p16ink4A as a predictive markers of tumor progression. Materials and methods. The study is based on analysis of 100 primary GISTs for description of their morphological features and 36 GISTs taken from this 100 for study of prognostic markers. Results. All spindle cell GISTs have shown diffuse expression of CD117 in tumor cells. The levels of CD117 expression varied from strong expression (3+) until mild expression (1+). Strong expression were seen in 75,8 % of spindle cell GISTs. Epithelioid GISTs demonstrated heterognous moderate or mild expression of CD117. All primary epithelioid GISTs from patients that had relapse of tumor in period from 1 till 3 years demonstrated focal mild expression of CD 117 in tumor cells. Expression of DOG-1 were seen in all 100 cases of GISTs, that were included in our study. The strong expression of DOG-1 (3+) were seen in all 45 GISTs that had low mitotic rate (≤5 mitoses per 50HPF) and not associated with their histological pattern. GISTs with high mitotic rate demonstrated heterogeneous expression of DOG-1 in tumors: moderate expression (2+) with patchy areas of strong expression (3+). Expression of CD56 was not found in spindle cell GISTs, but single tumor cells of epithelioid GISTs that had high mitotic rate demonstrated expression of this marker. The average expression of p16ink4A were higher in tumors that gave relapses compared with tumors without relapses (50,3 % versus 5,7 % respectively, U-test=16.5; p≤0,01).The average expression of MMP-9 also were significantly higher in GISTs that gave relapses: 63,2 % compared with 13,4 % in GISTs without relapse (U-test=16; p≤0 ,01).The strong VEGF expression was found in 66,7 % of GISTs that had relapses and only in 8,3 % of GISTs without relapses. 50 % of GISTs without relapses was negative for VEGF. Finally, the average expression of Ki-67 were 13,4 % in GISTs with relapses and 8,7 % in GISTs without them (U-test=16; p≤0,01). Conclusion. We highly recommend using DOG-1 for epithelioid GISTs. Additionally in epithelioid GISTs can be used CD56 that can give focal positive reaction in some tumour cells. The following minimal panel of markers for differential diagnosis of spindled GISTs from other mesenchymal tumors of gastrointestinal tract is proposed: CD117, DOG-1 and SMA, where the first too markers will demonstrated the moderate or strong diffuse expression and SMA can be occasionally positive in some tumor cells. p16ink4A, ki-67, VEGF and MMP-9 can be used as additional prognostic markers in GISTs.


2015 ◽  
Vol 56 (4) ◽  
pp. 432-438 ◽  
Author(s):  
Joshua Hobbs ◽  
James Sutherland-Smith ◽  
Dominique Penninck ◽  
Samuel Jennings ◽  
Lisa Barber ◽  
...  

PRILOZI ◽  
2015 ◽  
Vol 36 (1) ◽  
pp. 219-223
Author(s):  
Elizabeta Trajkovska ◽  
Vesna Janevska ◽  
Liljana Spasevska ◽  
Vlado Janevski ◽  
Julija Zhivadinovik ◽  
...  

Abstract Introduction: Gastrointestinal stromal tumors (GIST) are the most common mesenchymal tumors of the digestive tract. There is an increasing number of literature reports on synchronous occurrence of gastrointestinal stromal tumors and another malignancy of distinct etiology and evolution. The most reported cases include gastric synchronous occurrence of gastrointestinal stromal tumors and adenocarcinoma and gastric gastrointestinal stromal tumors and colonic adenocarcinoma. Case report: We present a case of a 77-old female, with synchronous cecal moderately differentiated adenocarcinoma in Stage IIA according to the TNM classification and ileal spindle cell type GIST with low malignant potential, positive for c-Kit, CD34, vimentin, Actin, and negative for S100. Conclusion: The synchronous occurrence of small bowel gastrointestinal stromal tumors and other primary gastrointestinal malignancies has been rarely reported. There is a need of further investigations to identify the relationship between gastrointestinal stromal tumors and colorectal cancers.


2019 ◽  
Vol 152 (Supplement_1) ◽  
pp. S67-S67
Author(s):  
Binny Khandakar ◽  
Sharmila Ghosh ◽  
Jihong Sun

Abstract Objectives Gastrointestinal stromal tumor (GIST) is the most common primary mesenchymal tumor of the gastrointestinal tract (GIT). Most tumors are of spindle cell type. Approximately 20% of the cases are of epithelioid histologic variant and approximately 10% are mixed epithelioid and spindle type. We sought to identify the clinical and pathologic features of GIST with epithelioid features diagnosed at our institute. Methods The database was searched (2017-2018) and 26 cases were included for the series. The data were analyzed systematically for histologic subtype, age, site, stage, risk group, and immunohistochemical findings. Results Pure epithelioid GIST (PE-GIST) was seen in nine cases (35%). Seventeen tumors were mixed subtype (M-GIST). PE-GIST was more common in females. Mean age of patients was similar in both subtypes. PE-GIST most commonly involved stomach (n = 8). Small intestine was the most commonly involved by M-GIST (n = 10). Mixed tumors were larger in size (6.0 cm, mean) compared to PE-GIST (4.2 cm, mean). Tumors showing pure epithelioid subtype were more in the high-risk category, compared to the mixed subtype (33% vs 23%). Most cases of M-GIST were pT3. M-GIST expressed both c-Kit and DOG-1 more frequently than the PE-GIST (70% vs 55%). Conclusion Mixed epithelioid and spindled GIST was more common than the pure form. Coexpression of DOG-1 and c-Kit was less frequent in PE-GIST. Mixed tumors tend to have higher stage than the pure type at presentation.


2010 ◽  
Vol 134 (1) ◽  
pp. 134-141 ◽  
Author(s):  
Javier A. Laurini ◽  
J. Elliot Carter

Abstract Gastrointestinal stromal tumors are mesenchymal neoplasms with a spectrum of histologic appearances and biologic activity. The morphologic classification of these lesions has evolved over time, and molecular analysis has led to a better understanding of their nature. The histologic differential diagnosis for these lesions is broad and includes many spindle cell lesions of the gastrointestinal tract, including neoplasms of true smooth muscle and neural origin, proliferating fibrous lesions, metastatic neoplasms, and primary sarcomas of vascular and adipose origin. Immunohistochemical studies that include CD117 have become invaluable in the classification of mesenchymal lesions arising in the gastrointestinal tract. Treatment of gastrointestinal stromal tumors has historically been involved surgery, but the use of the chemotherapeutic agent imatinib mesylate for advanced disease has made accurate classification even more important. The molecular features have not only allowed us to understand the pathogenesis of these tumors but also have proven to be associated with response to kinase inhibitors.


2016 ◽  
Vol 140 (10) ◽  
pp. 1038-1044 ◽  
Author(s):  
Nilam Virani ◽  
Judy Pang ◽  
Madelyn Lew

Spindle cell lesions of the gastrointestinal tract are relatively uncommon compared with the frequency of their epithelial counterparts. Although gastrointestinal stromal tumors and leiomyomas are the most commonly encountered spindle cell lesions in the stomach and esophagus, respectively, there are other less common diagnostic entities that should be considered for accurate diagnoses as well as appropriate patient treatment and clinical follow-up. Given the morphologic overlap of low-grade spindle cell lesions on cytologic preparations, ancillary studies play a key role in differentiating these lesions from one another.


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