Gastrointestinal stromal tumor (GIST), importance of macro-microscopic and immunohistochemical study to determine the risk of disease progression. About two cases
Gastrointestinal stromal tumors (GIST) are the most frequent mesenchymal neoplasms of the gastrointestinal tract, the stomach being the most involved organ. They originate from the interstitial Cajal cells of the myenteric plexus of the muscularis propria and most present mutations in the KIT proto-...
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| Formato: | Artículo revista |
| Lenguaje: | Español |
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Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología
2023
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| Acceso en línea: | https://revistas.unc.edu.ar/index.php/med/article/view/42742 |
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I10-R327-article-42742 |
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ojs |
| institution |
Universidad Nacional de Córdoba |
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I-10 |
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R-327 |
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Revista de la Facultad de Ciencias Médicas de Córdoba |
| language |
Español |
| format |
Artículo revista |
| topic |
GIST stomach progression Risk immunohistochemistry GIST estómago progresión Riesgo inmunohistoquimica . |
| spellingShingle |
GIST stomach progression Risk immunohistochemistry GIST estómago progresión Riesgo inmunohistoquimica . García Chiple , ME Alcain , WL Canals , NV Gastrointestinal stromal tumor (GIST), importance of macro-microscopic and immunohistochemical study to determine the risk of disease progression. About two cases |
| topic_facet |
GIST stomach progression Risk immunohistochemistry GIST estómago progresión Riesgo inmunohistoquimica . |
| author |
García Chiple , ME Alcain , WL Canals , NV |
| author_facet |
García Chiple , ME Alcain , WL Canals , NV |
| author_sort |
García Chiple , ME |
| title |
Gastrointestinal stromal tumor (GIST), importance of macro-microscopic and immunohistochemical study to determine the risk of disease progression. About two cases |
| title_short |
Gastrointestinal stromal tumor (GIST), importance of macro-microscopic and immunohistochemical study to determine the risk of disease progression. About two cases |
| title_full |
Gastrointestinal stromal tumor (GIST), importance of macro-microscopic and immunohistochemical study to determine the risk of disease progression. About two cases |
| title_fullStr |
Gastrointestinal stromal tumor (GIST), importance of macro-microscopic and immunohistochemical study to determine the risk of disease progression. About two cases |
| title_full_unstemmed |
Gastrointestinal stromal tumor (GIST), importance of macro-microscopic and immunohistochemical study to determine the risk of disease progression. About two cases |
| title_sort |
gastrointestinal stromal tumor (gist), importance of macro-microscopic and immunohistochemical study to determine the risk of disease progression. about two cases |
| description |
Gastrointestinal stromal tumors (GIST) are the most frequent mesenchymal neoplasms of the gastrointestinal tract, the stomach being the most involved organ. They originate from the interstitial Cajal cells of the myenteric plexus of the muscularis propria and most present mutations in the KIT proto-oncogene (exon 11). They usually present with abdominal pain and hemorrhage, and sometimes it is an incidental finding. In 25% of cases it has malignant behavior, but its complete resection improves the local recurrence rate and overall survival. Macroscopic and microscopic study is fundamental for its diagnosis. However, nowadays it is necessary to complement it with techniques such as immunohistochemistry (IHC) to determine both the cellular origin and to quantify the mitotic range. This is an indispensable element to evaluate the risk of progression of the disease, according to the protocol of the College of American Pathologists (CAP). The aim of this report is to present two cases of rare gastric mesenchymal tumors, undergoing surgery in the Pathology Department of Oulton Institute, which showed similar imaging, macroscopic, histopathologic and IHC characteristics.
In both cases partial gastrectomy specimens were received, with submucosal, unifocal nodular lesions, one 2 cm and the other 6.5 cm in diameter, microscopically exhibited mesenchymal cell proliferation, fused, swirling arrangement, with mitosis rate less than 5/25 CGA (high magnification fields), without necrosis and with free surgical margins. IHC profile: CD117, DOG1 and CD34 positive, S100, glial fibrillary acidic protein, smooth muscle actin and Vimentin negative. There was no risk of disease progression in the smaller tumor (0%) and LOW (3.6%) risk in the larger one.
The low frequency of these tumors makes diagnosis a great challenge. At present, in addition to the macro and microscopic study, the implementation of IHC allows us to determine the cellular origin and mitosis rate of the tumors to assess the risk of disease progression. |
| publisher |
Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología |
| publishDate |
2023 |
| url |
https://revistas.unc.edu.ar/index.php/med/article/view/42742 |
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I10-R327-article-427422023-10-19T21:19:26Z Gastrointestinal stromal tumor (GIST), importance of macro-microscopic and immunohistochemical study to determine the risk of disease progression. About two cases Tumor del estroma gastrointestinal (GIST), importancia del estudio macro-microscópico e inmunohistoquímico para determinar riesgo de progresión de la enfermedad. A propósito de dos casos . García Chiple , ME Alcain , WL Canals , NV GIST stomach progression Risk immunohistochemistry GIST estómago progresión Riesgo inmunohistoquimica . Gastrointestinal stromal tumors (GIST) are the most frequent mesenchymal neoplasms of the gastrointestinal tract, the stomach being the most involved organ. They originate from the interstitial Cajal cells of the myenteric plexus of the muscularis propria and most present mutations in the KIT proto-oncogene (exon 11). They usually present with abdominal pain and hemorrhage, and sometimes it is an incidental finding. In 25% of cases it has malignant behavior, but its complete resection improves the local recurrence rate and overall survival. Macroscopic and microscopic study is fundamental for its diagnosis. However, nowadays it is necessary to complement it with techniques such as immunohistochemistry (IHC) to determine both the cellular origin and to quantify the mitotic range. This is an indispensable element to evaluate the risk of progression of the disease, according to the protocol of the College of American Pathologists (CAP). The aim of this report is to present two cases of rare gastric mesenchymal tumors, undergoing surgery in the Pathology Department of Oulton Institute, which showed similar imaging, macroscopic, histopathologic and IHC characteristics. In both cases partial gastrectomy specimens were received, with submucosal, unifocal nodular lesions, one 2 cm and the other 6.5 cm in diameter, microscopically exhibited mesenchymal cell proliferation, fused, swirling arrangement, with mitosis rate less than 5/25 CGA (high magnification fields), without necrosis and with free surgical margins. IHC profile: CD117, DOG1 and CD34 positive, S100, glial fibrillary acidic protein, smooth muscle actin and Vimentin negative. There was no risk of disease progression in the smaller tumor (0%) and LOW (3.6%) risk in the larger one. The low frequency of these tumors makes diagnosis a great challenge. At present, in addition to the macro and microscopic study, the implementation of IHC allows us to determine the cellular origin and mitosis rate of the tumors to assess the risk of disease progression. Los tumores del estroma gastrointestinal (GIST) son las neoplasias mesenquimales más frecuentes del tracto gastrointestinal, siendo el estómago el órgano más comprometido. Se originan a partir de las células intersticiales de Cajal del plexo mientérico de la muscular propia y la mayoría presentan mutaciones en el protooncogén KIT (exón 11). Suelen presentarse con dolor abdominal y hemorragias, y a veces suele ser un hallazgo incidental. En un 25% de los casos tiene comportamiento maligno, pero su resección completa mejora la tasa de recidiva local y la supervivencia global. El estudio macro y microscópico es fundamental para su diagnóstico, pero en la actualidad es necesario complementar con técnicas como la inmunohistoquímica (IHQ) para determinar tanto el origen celular como para cuantificar el rango mitótico. Este es un elemento indispensable para evaluar el riesgo de progresión de la enfermedad, según protocolo del Colegio Americano de Patólogos (CAP). El objetivo del trabajo es presentar dos casos de tumores mesenquimales gástricos poco frecuentes, operados en el servicio de anatomía patológica del Instituto Oulton, los cuales mostraron similares características morfológicas, histopatológicas, imagenológicas y de IHQ. En ambos casos, se recibieron piezas de gastrectomía parciales, con lesiones nodulares submucosas, unifocales, una de 2 cm y la otra de 6,5 cm de diámetro, microscópicamente exhibieron una proliferación de células mesenquimales, fusadas, de disposición arremolinada, con rango mitótico menor a 5/25 CGA (campos de gran aumento), sin necrosis y con márgenes quirúrgicos libres. Perfil de IHQ: CD117, DOG1 y CD34 positivos, S100, Proteína gliofibrilar ácida, Actina músculo liso y Vimentina negativos. Riesgo de progresión de enfermedad: en el tumor de 2 cm fue NULO (0%) y en el de 6,5 cm fue BAJO (3,6%). La baja frecuencia de estos tumores hace que el diagnóstico sea un gran desafío; en la actualidad, además del estudio macro y microscópico, la implementación de IHQ nos permitió determinar el origen celular y el rango mitótico de los tumores para evaluar el riesgo de progresión de la enfermedad. . Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2023-10-19 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://revistas.unc.edu.ar/index.php/med/article/view/42742 Revista de la Facultad de Ciencias Médicas de Córdoba.; Vol. 80 (2023): Suplemento JIC XXIV Revista de la Facultad de Ciencias Médicas de Córdoba; Vol. 80 (2023): Suplemento JIC XXIV Revista da Faculdade de Ciências Médicas de Córdoba; v. 80 (2023): Suplemento JIC XXIV 1853-0605 0014-6722 spa https://revistas.unc.edu.ar/index.php/med/article/view/42742/42798 Derechos de autor 2023 Universidad Nacional de Córdoba http://creativecommons.org/licenses/by-nc/4.0 |