Mixed neuronal-glial tumor of the digestive tract: distinctive entity from gastrointestinal stromal tumor?
A 53-year-old-woman presenting with pelvic discomfort was found to have a 9.5 cm tumor located in the wall of the ileon. Light microscopy showed that the tumor was made of fascicles of plump spindle cells and bizarre epithelioid cells. A cuff of lymphoid cells was also present at the tumor margin. The tumor cells strongly expressed tau protein, neuron-specific enolase, protein green product 9.5 and glial fibrillary acid protein (GFAP), but did not show positive immunostaining for S-100 protein, CD34 or CD117. The tumor showed unequivocal ultrastructural evidence of neural differentiation. Skeinoid fibers were scattered throughout the tumor. This is the first mixed neuronal-glial tumor of the digestive tract to be described in the literature. Such histological and immunohistochemical features could be misinterpreted as features of digestive schwannoma. We suggest that this tumor is distinct from gastrointestinal stromal tumors in lacking CD34 and CD117 expression.
Chambonniere
Marie-Laure
ML
Department of Pathology, Bellevue Hospital, Saint-Etienne, France.
Mosnier-Damet
Michèle
M
Cavillon
Christophe
C
Mosnier
Jean-François
JF
D003937:Diagnosis, Differential; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000378:metabolism / Q000473:pathology; D005904:Glial Fibrillary Acidic Protein / Q000032:analysis; D006801:Humans; D007078:Ileal Neoplasms / Q000378:metabolism / Q000473:pathology* / Q000648:ultrastructure; D007082:Ileum / Q000737:chemistry / Q000473:pathology*; D007150:Immunohistochemistry; D008637:Mesenchymoma / Q000378:metabolism / Q000473:pathology* / Q000648:ultrastructure; D008854:Microscopy, Electron; D008875:Middle Aged; D010751:Phosphopyruvate Hydratase / Q000032:analysis; D017154:Stromal Cells / Q000737:chemistry / Q000473:pathology; D013869:Thiolester Hydrolases / Q000032:analysis; D043222:Ubiquitin Thiolesterase; D016875:tau Proteins / Q000032:analysis
D005904:Glial Fibrillary Acidic Protein; D016875:tau Proteins; D013869:Thiolester Hydrolases; D043222:Ubiquitin Thiolesterase; D010751:Phosphopyruvate Hydratase