Pathological Spectrum of Gastrointestinal Stromal Tumors - A 1.5-year Experience at Kidwai Cancer Institute
Journal Title: INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY - Year 2018, Vol 6, Issue 6
Abstract
Introduction: Gastrointestinal stromal tumors (GISTs) have an incidence of 10–15 per million per year worldwide. Majority of GISTs are located in the stomach (55.6%) followed by small bowel (31.8%). Some GISTs may be found outside the GIT, and they are referred to as extra-GISTs (EGISTs). The frequency of EGISTs is <1%. Cases of EGISTs have been reported in the retroperitoneum, mesentery, and omentum. GISTs are immunohistochemically positive for KIT (CD117), phenotypically paralleling Cajal cell differentiation and most examples contain KIT or PDGFRA activating mutations. Materials and Methods: A total of 37 cases of spindle cell neoplasm, suspected of GIST and 15 cases of other mesenchymal tumors of the GIT were studied. IHC panel of markers included KIT, DOG1, CD34, SMA, S-100, Desmin, CK, and a proliferation marker Ki67 performed on tumor blocks (Formalin fixed paraffin embedded tissue). KIT-negative cases were subjected to next-generation sequencing. Results: Gastrointestinal stromal tumor was the most common mesenchymal tumor of GIT with stomach being the most common site of involvement and the mean tumor size was 10.7 cms. Metastatic disease was present in 16.2% of cases while recurrences of GISTs were seen in 13.5% of cases. Combination of KIT and DOG1 highly improved the sensitivity of identifying cases of GIST. Of 3 cases which were KIT-negative by IHC, 2 cases showed mutational analysis consistent with GIST, and the other case was negative for both KIT and PDGFRA. Additional IHC for this case showed WT1 and D240 positivity and was diagnosed with malignant mesothelioma.
Authors and Affiliations
P Varsha, G Champaka, Rekha V Kumar, S Krishnamurthy
Keywords
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