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Ultrastructural studies of gastrointestinal stromal tumors.

Park SH, Kim MK, Kim H, Song BJ, Chi JG - J. Korean Med. Sci. (2004)

Bottom Line: Normal interstitial cells of Cajal (ICC) were abundantly present around the myenteric plexuses or individually scattered through the wall of GIT.ICC was characterized by slender cytoplasmic processes, well-developed endoplasmic reticulum (ER), mitochondria, Golgi apparatus, caveolae and intermediate filaments.Compared with ICC, the GISTs and GANTs had remarkably reduced caveolae and gap junctions.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, Seoul National University, College of Medicine, Seoul, Korea. shparknp@plaza.snu.ac.kr

ABSTRACT
Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors in the gastrointestinal tract (GIT). Although interstitial cells of Cajal has been suggested as origin of this tumor, the cytological and ultrastructural features of GISTs are heterogeneous and unclear. A total 10 cases of normal gastrointestinal tissue (control), 13 GISTs of the stomach (8), small intestine (3), mesocolon (1) and liver (1), and 2 gastrointestinal autonomic nervous tumor (GANT) of small intestine were ultrastructurally studied. Normal interstitial cells of Cajal (ICC) were abundantly present around the myenteric plexuses or individually scattered through the wall of GIT. ICC was characterized by slender cytoplasmic processes, well-developed endoplasmic reticulum (ER), mitochondria, Golgi apparatus, caveolae and intermediate filaments. The GISTs and GANTs had overlapping ultrastructures. The most common and important ultrastructural features of GISTs were rich villous cytoplasmic processes, dispersed intermediate filaments and abundant SER, and those of GANTs were neurosecretory granules and skenoid fibers. Compared with ICC, the GISTs and GANTs had remarkably reduced caveolae and gap junctions. Our study suggested that ultrastructural analysis gives much information to investigate lineage differentiation of neoplastic cells and make a differential diagnosis of these tumors from other mesenchymal tumors and between GISTs and GANTs.

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GANT reveals mainly epithelioid feature. Focal cytoplasmic vacuolization is seen. The tumor cells are robustly positive for CD117 (c-kit) but negative for CD34. S-100 protein, synaptophysin and NF are partially positive in neoplastic cells. Ki67 labelling index is high. (A: H&E, ×200, B: c-Kit, ×200, C: CD34, ×400, D: S100, ×200, E: left: Synaptophysin, right: Neurofilaments, ×400, F: Ki67 immunostaining, ×200).
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Figure 3: GANT reveals mainly epithelioid feature. Focal cytoplasmic vacuolization is seen. The tumor cells are robustly positive for CD117 (c-kit) but negative for CD34. S-100 protein, synaptophysin and NF are partially positive in neoplastic cells. Ki67 labelling index is high. (A: H&E, ×200, B: c-Kit, ×200, C: CD34, ×400, D: S100, ×200, E: left: Synaptophysin, right: Neurofilaments, ×400, F: Ki67 immunostaining, ×200).

Mentions: Among thirteen cases of GISTs, six were spindle cell type (Fig. 1), three epithelioid cell type (Fig. 2) and four mixed type. The two GANTs revealed mainly epithelioid feature (Fig. 3). However, the epithelioid cell type also had some spindle cells areas. The cytoplasm of most tumor cells was eosinophilic and abundant. Marked myxoid change was present in some cases. Focal cytoplasmic vacuolization was often seen. No signet ring-like or oncocytic cells or cells with a clear cytoplasm were noted. The spindle cell type tumors were arranged in interlacing fascicles or whorls. Generally mitotic counts were low but various in each case from 0/50 to 40/50 HPF. Hemorrhage and/or necrosis were present in 9/15 cases. Eleven cases were pure GIST, 2 cases were GIST with smooth muscle differentiation and 2 cases were GANT. According to the Miettinen et al. report (2002), two cases were malignant having metastasis, six cases were probably malignant, three cases were low malignant potential and two cases were categorized as probably benign. All GANTs were probably malignant. There was no case with lymph node metastasis.


Ultrastructural studies of gastrointestinal stromal tumors.

Park SH, Kim MK, Kim H, Song BJ, Chi JG - J. Korean Med. Sci. (2004)

GANT reveals mainly epithelioid feature. Focal cytoplasmic vacuolization is seen. The tumor cells are robustly positive for CD117 (c-kit) but negative for CD34. S-100 protein, synaptophysin and NF are partially positive in neoplastic cells. Ki67 labelling index is high. (A: H&E, ×200, B: c-Kit, ×200, C: CD34, ×400, D: S100, ×200, E: left: Synaptophysin, right: Neurofilaments, ×400, F: Ki67 immunostaining, ×200).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2822305&req=5

Figure 3: GANT reveals mainly epithelioid feature. Focal cytoplasmic vacuolization is seen. The tumor cells are robustly positive for CD117 (c-kit) but negative for CD34. S-100 protein, synaptophysin and NF are partially positive in neoplastic cells. Ki67 labelling index is high. (A: H&E, ×200, B: c-Kit, ×200, C: CD34, ×400, D: S100, ×200, E: left: Synaptophysin, right: Neurofilaments, ×400, F: Ki67 immunostaining, ×200).
Mentions: Among thirteen cases of GISTs, six were spindle cell type (Fig. 1), three epithelioid cell type (Fig. 2) and four mixed type. The two GANTs revealed mainly epithelioid feature (Fig. 3). However, the epithelioid cell type also had some spindle cells areas. The cytoplasm of most tumor cells was eosinophilic and abundant. Marked myxoid change was present in some cases. Focal cytoplasmic vacuolization was often seen. No signet ring-like or oncocytic cells or cells with a clear cytoplasm were noted. The spindle cell type tumors were arranged in interlacing fascicles or whorls. Generally mitotic counts were low but various in each case from 0/50 to 40/50 HPF. Hemorrhage and/or necrosis were present in 9/15 cases. Eleven cases were pure GIST, 2 cases were GIST with smooth muscle differentiation and 2 cases were GANT. According to the Miettinen et al. report (2002), two cases were malignant having metastasis, six cases were probably malignant, three cases were low malignant potential and two cases were categorized as probably benign. All GANTs were probably malignant. There was no case with lymph node metastasis.

Bottom Line: Normal interstitial cells of Cajal (ICC) were abundantly present around the myenteric plexuses or individually scattered through the wall of GIT.ICC was characterized by slender cytoplasmic processes, well-developed endoplasmic reticulum (ER), mitochondria, Golgi apparatus, caveolae and intermediate filaments.Compared with ICC, the GISTs and GANTs had remarkably reduced caveolae and gap junctions.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, Seoul National University, College of Medicine, Seoul, Korea. shparknp@plaza.snu.ac.kr

ABSTRACT
Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors in the gastrointestinal tract (GIT). Although interstitial cells of Cajal has been suggested as origin of this tumor, the cytological and ultrastructural features of GISTs are heterogeneous and unclear. A total 10 cases of normal gastrointestinal tissue (control), 13 GISTs of the stomach (8), small intestine (3), mesocolon (1) and liver (1), and 2 gastrointestinal autonomic nervous tumor (GANT) of small intestine were ultrastructurally studied. Normal interstitial cells of Cajal (ICC) were abundantly present around the myenteric plexuses or individually scattered through the wall of GIT. ICC was characterized by slender cytoplasmic processes, well-developed endoplasmic reticulum (ER), mitochondria, Golgi apparatus, caveolae and intermediate filaments. The GISTs and GANTs had overlapping ultrastructures. The most common and important ultrastructural features of GISTs were rich villous cytoplasmic processes, dispersed intermediate filaments and abundant SER, and those of GANTs were neurosecretory granules and skenoid fibers. Compared with ICC, the GISTs and GANTs had remarkably reduced caveolae and gap junctions. Our study suggested that ultrastructural analysis gives much information to investigate lineage differentiation of neoplastic cells and make a differential diagnosis of these tumors from other mesenchymal tumors and between GISTs and GANTs.

Show MeSH
Related in: MedlinePlus