Immunohistologic characterization of gastrointestinal stromal tumors

a study of 82 cases compared with 11 cases of leiomyomas.

C. K. Ma, Mahul Amin, E. Kintanar, M. D. Linden, R. J. Zarbo

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Abstract

The histogenesis of stromal tumors of the gastrointestinal tract (GIST) is still controversial. Recent immunohistologic and ultrastructural studies have been inconsistent and suggest various cells of origin. In view of these uncertainties, we studied the immuno-profiles of 82 cases of GISTs and 11 cases of stromal tumors that we classified as leiomyomas based on histology. The 82 cases of GIST were subclassified as spindle or epithelioid type stromal tumors based on the predominant pattern and further divided into benign (< 5 cm in size and < 5 mitosis/50 HPF), malignant (> 5 mitosis/50 HPF), and borderline lesions (> 5 cm and < 5 mitosis/50 HPF). A panel of antibodies was used to characterize differentiation toward myogenic cells [pan-muscle actin (HHF-35), alpha-smooth muscle actin (SMA) and desmin], Schwann cells (S-100 protein), enteric glial [(glial fibrillary acidic protein (GFAP)], and nerve cells (neurofilaments). All leiomyomas were strongly positive for the three muscle markers. Of the 82 GISTs, only four cases (5%) were positive for desmin. However, 63% (52 cases) were positive with anti-pan-muscle actins and 39% (32 cases) were positive with anti-SMA. Compared with gastric tumors, the positivity rates were much higher for small bowel tumors. Seventy-nine cases (96%) were positive for vimentin, only five cases and two cases were focally and weakly reactive for S-100 protein and GFAP respectively, and none stained for neurofilaments.(ABSTRACT TRUNCATED AT 250 WORDS)

Original languageEnglish (US)
Pages (from-to)139-144
Number of pages6
JournalModern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc
Volume6
Issue number2
StatePublished - Jan 1 1993
Externally publishedYes

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Gastrointestinal Stromal Tumors
Leiomyoma
Actins
Desmin
Intermediate Filaments
S100 Proteins
Glial Fibrillary Acidic Protein
Neoplasms
Mitosis
Smooth Muscle
Gastrointestinal Tract
Muscles
Schwann Cells
Vimentin
Neuroglia
Muscle Cells
Uncertainty
Stomach
Histology
Neurons

All Science Journal Classification (ASJC) codes

  • Pathology and Forensic Medicine

Cite this

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title = "Immunohistologic characterization of gastrointestinal stromal tumors: a study of 82 cases compared with 11 cases of leiomyomas.",
abstract = "The histogenesis of stromal tumors of the gastrointestinal tract (GIST) is still controversial. Recent immunohistologic and ultrastructural studies have been inconsistent and suggest various cells of origin. In view of these uncertainties, we studied the immuno-profiles of 82 cases of GISTs and 11 cases of stromal tumors that we classified as leiomyomas based on histology. The 82 cases of GIST were subclassified as spindle or epithelioid type stromal tumors based on the predominant pattern and further divided into benign (< 5 cm in size and < 5 mitosis/50 HPF), malignant (> 5 mitosis/50 HPF), and borderline lesions (> 5 cm and < 5 mitosis/50 HPF). A panel of antibodies was used to characterize differentiation toward myogenic cells [pan-muscle actin (HHF-35), alpha-smooth muscle actin (SMA) and desmin], Schwann cells (S-100 protein), enteric glial [(glial fibrillary acidic protein (GFAP)], and nerve cells (neurofilaments). All leiomyomas were strongly positive for the three muscle markers. Of the 82 GISTs, only four cases (5{\%}) were positive for desmin. However, 63{\%} (52 cases) were positive with anti-pan-muscle actins and 39{\%} (32 cases) were positive with anti-SMA. Compared with gastric tumors, the positivity rates were much higher for small bowel tumors. Seventy-nine cases (96{\%}) were positive for vimentin, only five cases and two cases were focally and weakly reactive for S-100 protein and GFAP respectively, and none stained for neurofilaments.(ABSTRACT TRUNCATED AT 250 WORDS)",
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AU - Linden, M. D.

AU - Zarbo, R. J.

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N2 - The histogenesis of stromal tumors of the gastrointestinal tract (GIST) is still controversial. Recent immunohistologic and ultrastructural studies have been inconsistent and suggest various cells of origin. In view of these uncertainties, we studied the immuno-profiles of 82 cases of GISTs and 11 cases of stromal tumors that we classified as leiomyomas based on histology. The 82 cases of GIST were subclassified as spindle or epithelioid type stromal tumors based on the predominant pattern and further divided into benign (< 5 cm in size and < 5 mitosis/50 HPF), malignant (> 5 mitosis/50 HPF), and borderline lesions (> 5 cm and < 5 mitosis/50 HPF). A panel of antibodies was used to characterize differentiation toward myogenic cells [pan-muscle actin (HHF-35), alpha-smooth muscle actin (SMA) and desmin], Schwann cells (S-100 protein), enteric glial [(glial fibrillary acidic protein (GFAP)], and nerve cells (neurofilaments). All leiomyomas were strongly positive for the three muscle markers. Of the 82 GISTs, only four cases (5%) were positive for desmin. However, 63% (52 cases) were positive with anti-pan-muscle actins and 39% (32 cases) were positive with anti-SMA. Compared with gastric tumors, the positivity rates were much higher for small bowel tumors. Seventy-nine cases (96%) were positive for vimentin, only five cases and two cases were focally and weakly reactive for S-100 protein and GFAP respectively, and none stained for neurofilaments.(ABSTRACT TRUNCATED AT 250 WORDS)

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