title: Clinicopathologic spectrum of gastro intestinal stromal tumours - experience at a tertiary care center.
abstract: BACKGROUND
  Accurate diagnosis of Gastrointestinal stromal tumors (GISTs) and categorization of risk groups is crucial in the wake of targeted drug therapy.
  
  
  OBJECTIVE
  This study was undertaken to obtain insight into the clinicopathologic features of GISTs.
  
  
  METHODS
  Retrospective study of 20 cases of c-KIT (CD 117) positive GISTs .Various histologic parameters were studied. Immunohistochemical panel included CD-34, Smooth muscle actin, S-100, Desmin, and Vimentin. Risk categorization was done as per standard protocol. Clinical details and follow up were retrieved from cases files.
  
  
  RESULTS
  Of the total 20 cases, 15 were males. The mean age of presentation was 52 years. 50 % of the cases presented with gastro intestinal bleeding. The cases were categorized as high risk (60%), intermediate risk (20%), low risk (15%) and very low risk (5%). Stomach and small intestine were commonly involved and in 6 of the cases there were metastatic nodules in the mesentery/omentum/ peritoneum. Spindle cell morphology was the commonest histological pattern (55%). Nuclear pleomorphism, perivascular whorling, mucosal and fat invasion were seen only in the high risk group. CD-34, SMA and S-100 were positive in 90%, 30%, and 10% of the cases, respectively, with consistent Desmin negativity.
  
  
  CONCLUSIONS
  Cases of GISTs in our clinical setting presented a decade earlier and mostly belonged to the high risk group. Certain histological features such as necrosis, and perivascular whorling were more commonly associated with the high risk groups.
authors.affiliation: Department of Pathology, St. John's Medical College and Hospital, Bangalore, India.
authors.forename: G
authors.initials: G
authors.lastname: Ravikumar
authors.forename: I Y
authors.initials: IY
authors.lastname: Kalegowda
authors.forename: A
authors.initials: A
authors.lastname: Ananthamurthy
mesh_terms: D018952:Antigens, CD34 / Q000378:metabolism; D005260:Female; D005500:Follow-Up Studies; D005770:Gastrointestinal Neoplasms / Q000453:epidemiology* / Q000473:pathology*; D046152:Gastrointestinal Stromal Tumors / Q000453:epidemiology* / Q000473:pathology*; D006761:Hospitals; D006801:Humans; D007150:Immunohistochemistry; D015994:Incidence; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D019009:Proto-Oncogene Proteins c-kit / Q000378:metabolism; D012189:Retrospective Studies; D012307:Risk Factors; D055512:Tertiary Prevention
chemical_list: D018952:Antigens, CD34; D019009:Proto-Oncogene Proteins c-kit