Midenin Senkron Gastrointestinal Stromal Tümör ve Primer Adenokarsinomu (original) (raw)
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Sakarya Medical Journal, 2020
Objective Gastrointestinal stromal tumor (GIST) is the most frequent mesenchymal tumor of the gastrointestinal tract, arises from or is differentiated towards interstitial cell of Cajal. The aim of this study is to review the demographic, histopathological and immunohistochemical characteristics of cases diagnosed with GIST in the light of the literature. Materials and Methods Forty-five GIST cases diagnosed between 2010 and 2018 in Kayseri City Hospital's pathology clinic were included in the study. The cases were reevaluated retrospectively by hematoxylin-eosin sections and immunohistochemical staining. Results Twenty-one of the cases (46.66%) were female, and 24 (53.33%) were male. The average age was 64.9 years. 4/45 (8.88%) of the cases included in the study were in the very low risk, 20/45 (44.44%) were in the low risk, 8/45 (17.77%) were in the intermediate risk, and 13/45 cases (28.88%) were in the high-risk group. Conclusion Histopathology and immunohistochemical studies are important for the accurate diagnosis, classification, prognosis, and treatment in GISTs. The centers should prepare their report formats according to internationally accepted report samples and consensus criteria, and significant macroscopic and microscopic findings and immunohistochemical examination results should be given as a list at the end of the report. Keywords gastrointestinal stromal tumors; histopathology; immunohistochemistry staining Öz Amaç Gastrointestinal stromal tümör (GİST), gastrointestinal sistemin en sık görülen mezenkimal tümörüdür, interstisyel Cajal hücresinden kaynaklanır veya farklılaşır. Bu çalışmanın amacı GIST tanılı olguların demografik, histopatolojik ve immünohistokimyasal özelliklerini literatür ışığında gözden geçirmektir. Gereç ve Yöntemler Çalışmaya Kayseri Şehir hastanesi patoloji kliniğinde, 2010-2018 yılları arasında tanı konulan 45 GİST olgusu dahil edildi. Olgular retrospektif olarak hematoksilen-eozin kesitleri ve immünohistokimyasal boyamaları ile yeniden değerlendirildi.
Evaluation of Gastro Intestinal Stromal Tumor in a Tertiary Care Center
International journal of pharmaceutical and bio-medical science, 2024
Gastrointestinal stromal tumour (GIST) is an uncommon entity in clinical practice. It accounts for only <1% of all Gastrointestinal (GI) malignancies. Stomach is the commonest site for this tumour. Other sites of GI tract are also affected with GIST. AIMS AND OBJECTIVES: This study aimed evaluate the prognostic factors, and recurrence patterns among the patients of eastern India. MATERIAL AND METHODS: This was a retrospective observational study which was conducted at the Department of Pathology in a tertiary care centre of eastern India. The specimens sent for HPE during the period June, 2018 to June, 2023 were included in the study. A total number of 2897 GI specimens sent to the Department for histopathological examinations were selected for the study. Out of which 77 specimens were diagnosed as GIST. The information of the vital parameters of the patient, type of tumour and type of treatments offered were collected for evaluation. The histological examinations relied on morphological features on Hematoxylin & Eosin stain and confirmation with immunohistochemistry markers CD34 and CD117 and S100. Patients with operable GIST underwent Surgery followed by adjuvant therapy. Patients with inoperable/ borderline operable disease underwent neoadjuvant Tab. Imatinib 400 mg/day followed by reassessment for surgery. RESULTS: The mean (±S.D.) age of the patients was 54.58±11.24 years with range of 28-74 years and the median age was 54 years. 66.2% of the patients were with age< 60 years (p<0.001). Proportion of females (54.5%) was higher than males (45.5%) but it was not significant. Stomach (54.5%) was the most common site of tumour which was significantly higher than small intestine (27.3%) and large intestine (18.2%) (p<0.0001). At presentation non-metastatic cases (62.3%) were significantly higher than metastatic (35.1%) and locally recurrent cases (2.6%) (p<0.0001). In most of the cases the mitotic rate was between 5-10 /50 HPF (53.2%) which was significantly higher than mitotic rate <5/50 HPF (32.5%) and >10/50 (14.3%) (p=0.0042). Spindle cell type tumour (71.4%) was significantly higher than mixed (Spindle and Epithelioid) (20.8%) and Epithelioid type tumour (7.8%) (p<0.0001). CONCLUSION: GIST is a rare tumor of the GI tract. It usually occurs in the stomach. The treatment of choice is surgery followed by adjuvant therapy.
GENERAL CHARACTERISTICS AND TREATMENT OPTIONS OF THE PATIENTS WITH GASTROINTESTINAL STROMAL TUMOR
National Journal of Medical Research, 2013
Background: Gastrointestinal stromal tumors (GIST) are rare mesenchimal tumors may develop in any site in the gastrointestinal system. KIT gene mutations are detected in 95% of cases. In this study, we aimed to assess treatment options and general characteristics of patients with GIST. Methods: GIST patients admitted to Abdurrahman Yurtaslan Oncology Education and Training hospital’s oncology clinic between February 2009 and May 2012 are observed retrospectively. Demographic characteristics of the patients and the treatment they received were recorded from hospital’s database. Results: Eighteen patients included to study havinng Mean age of 57.8 years (32-78). Five (28%) of the patients were female and thirteen (72%) were male. Diagnosis were made in 16 patients by pathological assessment of surgical material. Trucut biopsy and gastroscopic biopsy used for diagnosis in remaining two patients. Localizations of the tumor were as follows: small intestine in 9 patients, colon in 5 patients, stomach in 4 patients. All of the patients were KIT positive. Tumor was defined at high risk in 62%, at moderate risk in 17% and at low risk in 21% of the cases. Imatinib was administered in 5 patients with metastatic disease. Mean follow up period for the patients was 48 months. Relapse or progression developed in 4 of all patients in follow up period. Only one of the five patients with metastaic disease developed progression. Other 3 cases were relapsed. Conclusion: Surgical resection of tumor without fragmentatin is the main treatment of localized GIST cases. Imatinib, a tyrosine kinase inhibitor, is used in metastatic/ inoperable tumors and in cases at high risk for metastasis, recently. In conclusion, after surgical resection of the tumor, we suggest Imatinib treatment in patients considered at high risk.
Gastrointestinal stromal tumors: A clinical and histopathological presentation of 27 cases
Turkish Journal of Surgery
Objective: Gastrointestinal stromal tumors (GISTs) are mesenchymal tumors that express type 3 tyrosine kinase receptors and are thought to develop from the neoplastic transformation of the interstitial Cajal cells. The present study was performed to morphologically and immunohistologically evaluate GISTs, to compare their qualities using a GIST risk categorization system, and to identify the diagnostic and prognostic parameters of GISTs. Material and Methods: A total of 27 patients with GISTs underwent treatment and were followed up at the Gaziosmanpaşa Taksim Training and Research Hospital. Descriptive statistics was used to calculate the mean and median values. Survival analysis was performed by the Kaplan-Meier method. The analyses were performed using the SPSS version 22.0 software. Results: The mean follow-up time was 3.5 (5 months to 13 years) years. The mean age was 60.4 (29-82) years. The tumors were localized in the stomach (62.9%), extraintestinal areas (14.8%), intestine (7.4%), esophagus (7.4%), and rectum (7.4%). Twenty-four patients were classified according to the Fletcher system. Of these patients, 7 (25.9%) were classified as very low risk, 8 (29.6%) as low risk, 7 (25.9%) as intermediate risk, and 2 (7.4%) as high risk. Twenty-four patients underwent surgery. Of the 3 patients who did not undergo surgery, 1 had metastatic disease at the time of diagnosis, and 2 had mini-or micro-GISTs in the stomach. On endoscopic surveillance, all tumors remained stable. Three out of the 27 patients were lost to follow-up. Two patients developed recurrence, and 1 patient died of GIST. Conclusion: We analyzed the clinical and pathological characteristics of GIST. The most common site of tumor origin was the stomach. The size, mitotic index, and Ki-67 values were to be found high in intermediate-and high-risk groups and metastatic diseases.
Objective: This study aimed to understand clinicopathological characteristics of gastrointestinal stromal tumors (GISTs) and correlation between pathologic features and clinical outcome. Methods: We used 76 cases diagnosed as primary GISTs during January 2007 to July 2017 at Army Institute of Pathology, Thailand. Clinical, survival, and pathological data were collected and analyzed. Results: Ages of the patients ranged from 15 to 88 years (M:F = 1:1). The most common presentation was gastrointestinal bleeding (39.7%). The most common site was the stomach (64.5%). Tumor size ranged from 0.6 to 25.5 cm (average 8.78 cm). Histologic types were spindle cell type (75%), mixed spindled-epithelioid type (17.1%), and epithelioid type (7.9%). The majority of histologic subtype was diffuse hypercellularity (67.1%). Tumor necrosis was found in 38.1% and 80% showed low mitotic counts. Most gastrointestinal stromal tumors (27.6%) are low-risk category according to Miettinen and Lasota's algorithm. Metastasis was found in 27.7%, mostly occurs within 2 years, and is correlated with tumor size > 10 cm (P = 0.023), non-spindle cell histologic type (P = 0.027), mitotic count > 5/5mm 2 (P = 0.000), myxoid change (P = 0.011), and mucosal invasion (P = 0.002). Recurrence was found in 8.1%, mostly occurs within 7 years, and correlated with myxoid change (P = 0.045). Conclusion: We found that most of GISTs show spindle cell type and low-risk category. Metastasis was correlated with tumor size > 10 cm, non-spindle cell histologic type, mitotic count > 5/5mm 2 , myxoid change, and mucosal invasion. Recurrence was correlated with myxoid change.
Northern Clinics of Istanbul, 2019
G astrointestinal stromal tumors (GIST) are mesenchymal tumors with specific histological featuresand are primarily localized in the gastrointestinal system and abdomen. GISTs are a rare tumor group, accounting for less than 1% of primary gastrointestinal system tumors. It is difficult to predict the clinical behaviour of GISTs [1]. GISTs may be seen anywhere along the gastrointestinal system, but the most common localizations are the stomach (50-60%) and small intestine (20-30%). These tumors are seen in the large intestine by 10% and in the esophagus by 5% [2]. The lesions that cannot be distinguished from GISTs concerning mor-ABSTRACT OBJECTIVE: In this study, we reviewed GISTs with all morphological and immunohistochemical findings and assessed the prognostic parameters of these tumors. METHODS: Files of 40 cases with GIST operated between 2002 and 2008 were retrospectively examined in this study. Patients were grouped as patients with and without recurrence within postop 1 year. The patients were grouped based on their localization, gender and age. The cases were stratified as the risk grades based on risk categorization table developed by Fletcher et al. according to the tumor diameter and number of mitoses. The cases were immunohistochemically investigated for CD117, CD34, S100, and Ki-67. RESULTS: Male/female ratio was 25/15. The mean age was 61.55. Mean tumor diameters were statistically significantly higher in the recurrence (+) group than in the recurrence (-) group (p=0.048). The mean number of mitoses was statistically significantly higher in the recurrence (+) group than in the recurrence (-) group (p=0.038). No statistically significant difference was found in histological distribution of the recurrence (-) and recurrence (+) groups (p=0.8795). No statistically significant difference was found in CD34, S100, and Ki-67 distribution of the recurrence (-) and recurrence (+) groups (p=0.862, p=0.609, and p=0.023, respectively). All patients in the recurrence (+) group were in the high-risk group. CONCLUSION: GISTs are studied in a wide range from benign, incidental tumors to malignant tumors with the risk for recurrence and metastasis concerning biological behaviour. GISTs have prognostic parameters, such as tumor localization, tumor diameter, mitotic index, cellularity, and pleomorphism grade.
Selcuk Tip Dergisi, 2018
Amaç: Gastrointestinal stromal tümörler (GİST); gastrointestinal traktın en sık görülen mezenkimal tümörleridir. Gastrointestinal sistemin peristaltizmini düzenleyen interstisyel Cajal hücrelerinden köken aldıkları düşünülmektedir. Gastrointestinal stromal tümörler farklı morfolojik ve biyolojik davranış özellikleri ile heterojen bir tümör grubudur bu nedenle farklı ülkelerde farklı epidemiyolojik, klinikopatolojik ve prognostik özellikler sergileyebilmektedir. Bu çalışmanın amacı, son 10 yılda GİST tanısı alan 100 olgunun histopatolojik, immünhistokimyasal özellikleri ve risk gruplarının analizini yapmaktır. Hastalar ve Yöntem: 2006-2016 yılları arasında patoloji laboratuarımızda GİST tanısı alan 100 olgu retrospektif olarak incelendi. Olguların çap ve mitoz oranlarına göre risk grupları belirlendi. Çap ve mitoz dışındaki histopatolojik ve immünohistokimyasal özellikleri ile risk grupları arasındaki ilişki analiz edildi. Verilerin analizinde Chi-kare-Fischer testleri kullanıldı. Bulgular: Olgularımızda yaş ve cinsiyet dağılımı risk gruplarına göre değişmemektedir. En çok; sırası ile kolorektal, ekstra gastrointestinal sistem (mezental, omental ve retroperiton), ince barsak ve mide GİST leri yüksek risk grubunda yer almaktadır. İnce barsak, kolorektal ve ekstra gastrointestinal tümörler daha büyük çaplı olup mide tümörleri daha küçük çaplıdır. İmmünhistokimyasal CD-34, S-100, SMA, desmin ekspresyonu ile risk grupları ilişkili değildir. Ki-67 %10' un üzerinde ekspresyon gösteren tümörler yüksek risk grubunda yer almaktadırlar. Mide ve ekstra gastrointestinal tümörler daha fazla CD-34 ekspresyonu göstermektedir. Nekroz ve kanama gösteren tümörler ile selüleritesi yüksek tümörlerin bir üst risk grubunda olma oddsları artmıştır. Ülserasyon, büyüme paterni ve atipi ile risk grupları arasında ilişki mevcut değildir. Sonuç: GİST ler gastrointestinal sistemin nadir tümörlerinden olup farklı bölgelerde, farklı varyasyonlarda ortaya çıkabilirler. GİST lerin histopatolojik ve immünhistokimyasal olarak detaylı incelenmesi ve risk gruplarına göre klasifiye edilmesi klinik tedavi ve takipte önemli rol oynamaktadır.
European Journal of Surgical Oncology
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Profile of patients with gastrointestinal stromal tumors (GIST)
ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo), 2015
BACKGROUND: There is an improvement on the GIST treatment in last decade due to biomolecular research and adjuvant therapy with tyrosine kinases inibitors. However, both modalities of treatment rarely are available in Brazilian public hospital. AIM: Evaluate GIST patients profile in public oncologic hospital. METHODS: A retrospective study was made on patients with GIST diagnosed and treated between 2001 and 2013. RESULTS: Sixty-nine patients were included, mean age 59 years with slight predominance in females (51%). The main symptom was abdominal pain associated with incidental imaging finding. The occurrence of other associated neoplasm was in 28.8% of cases. The positivity of CD117 was 97.1%. The most frequent location was the stomach in 55.1% of cases. The R0 resection was possible in 63.8% and the recurrence rate was 20.3 %, with liver and peritoneum the main affected sites. Overall survival in the whole sample was 71%. Free survival rate of disease was 64%. The use of imatinib...
PRILOZI, 2015
Introduction: Gastrointestinal stromal tumors (GIST) are the most common mesenchymal tumors of the digestive tract. There is an increasing number of literature reports on synchronous occurrence of gastrointestinal stromal tumors and another malignancy of distinct etiology and evolution. The most reported cases include gastric synchronous occurrence of gastrointestinal stromal tumors and adenocarcinoma and gastric gastrointestinal stromal tumors and colonic adenocarcinoma.Case report: We present a case of a 77-old female, with synchronous cecal moderately differentiated adenocarcinoma in Stage IIA according to the TNM classification and ileal spindle cell type GIST with low malignant potential, positive for c-Kit, CD34, vimentin, Actin, and negative for S100.Conclusion: The synchronous occurrence of small bowel gastrointestinal stromal tumors and other primary gastrointestinal malignancies has been rarely reported. There is a need of further investigations to identify the relationshi...