Gastro-intestinal stromal tumours (GISTs): a six year Zimbabwean experience. Cellular differentiation with immunocytochemistry.
OBJECTIVE
To determine the prevalence of GISTs in general, the terminology in use, biological behaviour in terms of benign, borderline and malignant variants and assessment of the different lines of differentiation using immunochemical techniques.


METHODS
A retrospective study.


METHODS
Department of Histopathology, University of Zimbabwe Medical School at Parirenyatwa and Harare Central teaching Hospitals.


METHODS
Patients with a surgical pathology diagnosis of gastro-intestinal related stromal tumours including leiomyosarcomas, leiomyomas and GISTs over a six year period.


METHODS
Evaluation for different lines of differentiation and malignant potential using immunocytochemical techniques.


RESULTS
A total of 24 cases with a primary diagnosis of GISTs over a period of six years were retrieved from the records and of these 22 had material available for evaluation. Four of these were reported as pure GISTs, two of them benign and the other two malignant. Seven cases were reported as leiomyosarcomas. Six of these had evidence of neural differentiation on immunocytochemistry and therefore were strictly not leiomyosarcomas. Of the 11 cases reported as leiomyomas, four (36.4%) had neural differentiation on immunohistochemistry implying a low malignant potential.


CONCLUSIONS
GISTs are not uncommon in this patient population considering that 24 cases were reported over a six year period in a department that averages 11,000 surgical pathology cases per year. Minimal use of immunostains, in addition to general morphological features, can be utilized to determine the line of cellular differentiation and malignant potential of the seemingly benign tumours.
Hove
M G
MG
Department of Histopathology, University of Zimbabwe, Harare, Zimbabwe. maxhove1@hotmail.com
Kasiya
W
W
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D003937:Diagnosis, Differential; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000453:epidemiology* / Q000473:pathology*; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods; D007889:Leiomyoma / Q000453:epidemiology* / Q000473:pathology*; D007890:Leiomyosarcoma / Q000453:epidemiology* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D018235:Smooth Muscle Tumor / Q000453:epidemiology* / Q000473:pathology*; D017154:Stromal Cells / Q000473:pathology*; D009626:Terminology as Topic; D015030:Zimbabwe / Q000453:epidemiology