title: A limited immunocytochemical panel for the distinction of subepithelial gastrointestinal mesenchymal neoplasms sampled by endoscopic ultrasound-guided fine-needle aspiration.
abstract: We studied the use of immunocytochemical analysis with material procured by endoscopic ultrasound-guided fine-needle aspiration (EUS-guided FNA) for the diagnosis of subepithelial intramural gastrointestinal (GI) mesenchymal neoplasms (SIGIMNs). We identified all EUS-guided FNA specimens of SIGIMNs that had undergone immunocytochemical analysis. Results were compared with follow-up histologic diagnoses. There were 95 aspirates that were diagnosed as GI mesenchymal tumors (GI stromal tumors [GISTs], n = 46), leiomyomas (n = 38), peripheral nerve sheath tumors (n = 5), and other neoplasms by cytologic examination. Immunoreactivity with antibodies to CD117 always predicted GIST at follow-up; 15 of 16 cases immunoreactive with antibodies to CD34 were found to be GISTs at follow-up. Strong immunoreactivity with antibodies to smooth muscle actin or desmin usually predicted a leiomyoma at follow-up aside from a single glomus tumor and a case with apparent nonneoplastic smooth muscle contaminant. When sufficient material is present, immunocytochemical analysis used with material obtained by EUS-guided FNA is highly predictive of final pathologic diagnosis.
authors.affiliation: Department of Pathology, University of Virginia, Charlottesville 22908, USA.
authors.forename: Edward B
authors.initials: EB
authors.lastname: Stelow
authors.forename: Faris M
authors.initials: FM
authors.lastname: Murad
authors.forename: Steven M
authors.initials: SM
authors.lastname: Debol
authors.forename: Michael W
authors.initials: MW
authors.lastname: Stanley
authors.forename: Ricardo H
authors.initials: RH
authors.lastname: Bardales
authors.forename: Rebecca
authors.initials: R
authors.lastname: Lai
authors.forename: Shawn
authors.initials: S
authors.lastname: Mallery
mesh_terms: D044963:Biopsy, Fine-Needle / Q000379:methods*; D019160:Endosonography; D005770:Gastrointestinal Neoplasms / Q000175:diagnosis*; D046152:Gastrointestinal Stromal Tumors / Q000175:diagnosis*; D006801:Humans; D007150:Immunohistochemistry; D007889:Leiomyoma / Q000175:diagnosis*; D009442:Neurilemmoma / Q000175:diagnosis*; D011237:Predictive Value of Tests