Differential diagnosis of a gastric stromal tumor: case report and literature review.
Gastrointestinal stromal tumors account for 0.1-3% of all gastrointestinal neoplasms and are characterized by features that overlap with those of other mesenchymal tumors. We expose the case of a 58-year-old male patient who complained of abdominal pain, weakness and melena. Microscopic examination of surgically resected gastric tumor revealed a neoplastic proliferation composed of spindle cells with eosinophilic cytoplasm, elongated nuclei with rounded ends, palisadic disposition and intracytoplasmic perinuclear vacuoles, low cyto-nuclear polymorphism, mild atypia and mitotic activity of 3-5÷50 HPF. Some histopathological features requested differential diagnosis with schwannoma and tumors of myocytary origin, based on immunohistochemical techniques, which have established a final diagnosis of spindle cell gastric stromal tumor. We also reviewed the GIST-related literature and evaluated the possible methods of preoperative diagnosis of GISTs based on endoscopic biopsy. Proper classification of GISTs based on histopathological criteria and immunohistochemical techniques has a great prognostic and therapeutic utility. Future development of endoscopic biopsy methods will refine the management of gastrointestinal stromal tumors.
Department of Pathology, Faculty of Medicine, Ovidius University, Constanta, Romania. mbosoteanu@yahoo.com
Mădălina
M
Boşoteanu
C
C
Boşoteanu
Mariana
M
Deacu
Mariana
M
Aşchie
D018952:Antigens, CD34 / Q000378:metabolism; D049109:Cell Proliferation; D003893:Desmin / Q000378:metabolism; D003937:Diagnosis, Differential; D046152:Gastrointestinal Stromal Tumors / Q000175:diagnosis* / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019009:Proto-Oncogene Proteins c-kit / Q000378:metabolism; D012307:Risk Factors; D009418:S100 Proteins / Q000378:metabolism; D014617:Vacuoles / Q000473:pathology
D018952:Antigens, CD34; D003893:Desmin; D009418:S100 Proteins; D019009:Proto-Oncogene Proteins c-kit