Limits...
Cytokeratin-positive gastrointestinal stromal tumor of biphasic morphology: a case report.

Kim SS, Choi YD, Lee JH, Choi C - Korean J Pathol (2014)

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, Chonnam National University Medical School, Gwangju, Korea.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Gastrointestinal stromal tumor (GIST), which is associated with mutations in KIT or a platelet-derived growth factor receptor, alpha polypeptide (PDGFRA), is the most common mesenchymal tumor of the gastrointestinal tract... In such cases, a diagnosis of GIST can be made when DOG1 immunoreactivity or mutation of KIT or PDGFRA are observed... A 44-year-old man was referred for evaluation of pain in his right foot... Laboratory test results, including electrolyte levels and blood-cell counts, were all within normal range... There was no transition area between the epithelioid and spindle-cell areas (Fig. 2A)... Mitotic figures were found at more than 10 per 50 high-power fields in both epithelioid and spindle-cell areas... Interestingly, the expressions of CD34 and CK were mutually exclusive between the epithelioid and spindle-cell areas... Direct sequencing of the KIT gene was performed in both sense and antisense directions in order to verify the results, using formalin-fixed, paraffin-embedded tissue from both areas and an ABI Prism 3100 Genetic Analyzer (Applied Biosystems, Grand Island, NY, USA), following the supplier’s recommendations... CK expression in GIST using monoclonal CK antibodies, such as CK18 or CK8, has been evaluated in several studies, and these studies support the conclusion that CK-immunoreactivity is more frequently noted in the epithelioid area than in the spindle-cell area (Table 1)... Thus, it seems that a higher rate of CK-immunoreactivity in epithelioid GIST might be due to a selection bias... In addition to GIST, CK-positivity has been observed in some mesenchymal tumors with epithelioid morphology, such as epithelioid angiosarcoma, epithelioid sarcoma, Ewing’s sarcoma/primitive neuroectodermal tumor, leiomyosarcoma, or schwannoma... Aberrant expression of CK is known to be a result of aberrant synthesis of CK by tumor cells or cross-reactivity to other intermediate filament proteins... We presented a case of GIST with a biphasic (mixed epithelioid and spindle cells) phenotype and distinct immunohistochemical profiles... CK immunoreactivity in the epithelioid area can be a diagnostic challenge unless tumor cells reveal immunoreactivity for c-Kit and DOG1.

No MeSH data available.


Related in: MedlinePlus

The cut surface of the tumor shows a well circumscribed mass with extensive hemorrhagic necrosis at the center. Solid areas (tan-gray colored regions) are noted at the periphery.
© Copyright Policy
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4215964&req=5

f1-kjpathol-48-5-375: The cut surface of the tumor shows a well circumscribed mass with extensive hemorrhagic necrosis at the center. Solid areas (tan-gray colored regions) are noted at the periphery.

Mentions: Macroscopically, the mass was located on the serosal surface of the small bowel. It showed hemorrhage and necrosis in the center. The peripheral solid portion was tan-gray and soft in consistency. The central hemorrhagic and necrotic area was ragged in appearance (Fig. 1). Microscopically, the hemorrhagic and necrotic portion was exclusively composed of epithelioid cells. The peripheral solid portion revealed both epithelioid and spindle cells. There was no transition area between the epithelioid and spindle-cell areas (Fig. 2A). Mitotic figures were found at more than 10 per 50 high-power fields in both epithelioid and spindle-cell areas. According to the National Institutes of Health (NIH) consensus criteria[1], the lesion was graded as a high risk of aggressive behavior.


Cytokeratin-positive gastrointestinal stromal tumor of biphasic morphology: a case report.

Kim SS, Choi YD, Lee JH, Choi C - Korean J Pathol (2014)

The cut surface of the tumor shows a well circumscribed mass with extensive hemorrhagic necrosis at the center. Solid areas (tan-gray colored regions) are noted at the periphery.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4215964&req=5

f1-kjpathol-48-5-375: The cut surface of the tumor shows a well circumscribed mass with extensive hemorrhagic necrosis at the center. Solid areas (tan-gray colored regions) are noted at the periphery.
Mentions: Macroscopically, the mass was located on the serosal surface of the small bowel. It showed hemorrhage and necrosis in the center. The peripheral solid portion was tan-gray and soft in consistency. The central hemorrhagic and necrotic area was ragged in appearance (Fig. 1). Microscopically, the hemorrhagic and necrotic portion was exclusively composed of epithelioid cells. The peripheral solid portion revealed both epithelioid and spindle cells. There was no transition area between the epithelioid and spindle-cell areas (Fig. 2A). Mitotic figures were found at more than 10 per 50 high-power fields in both epithelioid and spindle-cell areas. According to the National Institutes of Health (NIH) consensus criteria[1], the lesion was graded as a high risk of aggressive behavior.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, Chonnam National University Medical School, Gwangju, Korea.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Gastrointestinal stromal tumor (GIST), which is associated with mutations in KIT or a platelet-derived growth factor receptor, alpha polypeptide (PDGFRA), is the most common mesenchymal tumor of the gastrointestinal tract... In such cases, a diagnosis of GIST can be made when DOG1 immunoreactivity or mutation of KIT or PDGFRA are observed... A 44-year-old man was referred for evaluation of pain in his right foot... Laboratory test results, including electrolyte levels and blood-cell counts, were all within normal range... There was no transition area between the epithelioid and spindle-cell areas (Fig. 2A)... Mitotic figures were found at more than 10 per 50 high-power fields in both epithelioid and spindle-cell areas... Interestingly, the expressions of CD34 and CK were mutually exclusive between the epithelioid and spindle-cell areas... Direct sequencing of the KIT gene was performed in both sense and antisense directions in order to verify the results, using formalin-fixed, paraffin-embedded tissue from both areas and an ABI Prism 3100 Genetic Analyzer (Applied Biosystems, Grand Island, NY, USA), following the supplier’s recommendations... CK expression in GIST using monoclonal CK antibodies, such as CK18 or CK8, has been evaluated in several studies, and these studies support the conclusion that CK-immunoreactivity is more frequently noted in the epithelioid area than in the spindle-cell area (Table 1)... Thus, it seems that a higher rate of CK-immunoreactivity in epithelioid GIST might be due to a selection bias... In addition to GIST, CK-positivity has been observed in some mesenchymal tumors with epithelioid morphology, such as epithelioid angiosarcoma, epithelioid sarcoma, Ewing’s sarcoma/primitive neuroectodermal tumor, leiomyosarcoma, or schwannoma... Aberrant expression of CK is known to be a result of aberrant synthesis of CK by tumor cells or cross-reactivity to other intermediate filament proteins... We presented a case of GIST with a biphasic (mixed epithelioid and spindle cells) phenotype and distinct immunohistochemical profiles... CK immunoreactivity in the epithelioid area can be a diagnostic challenge unless tumor cells reveal immunoreactivity for c-Kit and DOG1.

No MeSH data available.


Related in: MedlinePlus