Clinicopathologic spectrum of gastro intestinal stromal tumours - experience at a tertiary care center.

Authors: Ravikumar G Kalegowda IY Ananthamurthy A
Address: Department of Pathology, St. John's Medical College and Hospital, Bangalore, India.
Journal:

Publication:

abstract

CONTEXT:

Accurate diagnosis of gastrointestinal stromal tumors (GISTs) and categorization of risk groups is crucial in the wake of targeted drug therapy.

AIM:

This study was undertaken to obtain insight into the Clinicopathologic features of GISTs.

MATERIALS AND 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.

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