title: Gastro-intestinal stromal tumors: an ultrastructural reinterpretation of the clear cell component.
abstract: The histology, immunohistochemistry and ultrastructure of six gastro-intestinal stromal tumors of the stomach (GSTs) showing a focal to diffuse clear cell component are reported. At light microscopy, all GSTs had typical histopathological features with one case additionally displaying stromal myxoid changes and scattered multinucleated giant cells. Immunohistochemically, 6 of 6 GSTs stained positive for vimentin, 2 of 6 for smooth muscle specific actin and 1 of 6 for desmin. At electron microscopy, GSTs showed microfilaments with focal densities as well as other smooth muscle features, such as subplasmalemmal linear densities and foci of external lamina. Ultrastructural appearances of tumor cells with clear cell features showed these not to be an artifact of fixation, but the expression of an unusual cytophagocytic activity. Inclusions of auto- and heterophagocytic nature were found responsible for the origin of the large, mostly lipidic vacuoles which displaced cell nuclei peripherally in a signet-ring fashion. It is concluded that such previously unrecognized features are ultrastructural aspects of GSTs with smooth muscle differentiation.
authors.affiliation: Institute of Clinical Electron Microscopy, S. Orsola Hospital, University of Bologna, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Pasquinelli
authors.forename: B
authors.initials: B
authors.lastname: Severi
authors.forename: G N
authors.initials: GN
authors.lastname: Martinelli
authors.forename: D
authors.initials: D
authors.lastname: Santini
authors.forename: M C
authors.initials: MC
authors.lastname: Gelli
authors.forename: V
authors.initials: V
authors.lastname: Tison
mesh_terms: D000328:Adult; D000368:Aged; D003593:Cytoplasm / Q000648:ultrastructure*; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000737:chemistry / Q000648:ultrastructure*; D006801:Humans; D002479:Inclusion Bodies / Q000648:ultrastructure*; D008297:Male; D008875:Middle Aged; D009379:Neoplasms, Muscle Tissue / Q000737:chemistry / Q000648:ultrastructure*; D009380:Neoplasms, Nerve Tissue / Q000737:chemistry / Q000648:ultrastructure*; D010751:Phosphopyruvate Hydratase / Q000032:analysis; D009418:S100 Proteins / Q000032:analysis; D017154:Stromal Cells / Q000648:ultrastructure
chemical_list: D009418:S100 Proteins; D010751:Phosphopyruvate Hydratase