A limited immunocytochemical panel for the distinction of subepithelial gastrointestinal mesenchymal neoplasms sampled by endoscopic ultrasound-guided fine-needle aspiration.
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.
Stelow
Edward B
EB
Department of Pathology, University of Virginia, Charlottesville 22908, USA.
Murad
Faris M
FM
Debol
Steven M
SM
Stanley
Michael W
MW
Bardales
Ricardo H
RH
Lai
Rebecca
R
Mallery
Shawn
S
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