Authors : B Deepthi, B Deepthi, Aruna Kumari Prayaga, Aruna Kumari Prayaga
DOI : 10.18231/j.ijpo.2019.126
Volume : 6
Issue : 4
Year : 2019
Page No : 658-670
Introduction: Mesenchymal tumours of gastrointestinal tract are a heterogenous group of nonepithelial
tumours of variable mesenchymal cell histogenesis. Gastrointestinal stromal tumour (GIST) is
the most common primary mesenchymal tumour of the gastrointestinal tract and spans a clinical
spectrum from benign to malignant. This study evaluated the clinicopathological morphological and
immunohistochemical features of GIST of the intestinal tract.
Materials and Methods: All evaluable cases of mesenchymal tumors of the gastrointestinal
tract were studied from January 2007 to December 2012. Tissue microarray was constructed and
Immunohistochemical expression of CD 117, CD 34, DOG1, SMA, S100, Ki 67 were studied.
Results: Gastrointestinal stromal tumours were the most common mesenchymal tumours of the
gastrointestinal tract accounting to 77.96%. The median age of presentation was 51 years with near equal
sex preliction with early clinical presentation. The gastric tumours were of significantly bigger size with
increased expression of CD 34. Majority of tumors were of bigger size (>10 cm, 47%) thereby increased
number of tumours in high risk category (76%). Spindle cell pattern was the most common morphology
(69.5%). Epitheliod histology was significantly associated with pleomorphism and atypia (p value – 0.029).
Inclusion of anatomic site into the risk category will help in better stratificaion. High risk tumours showed
significant areas of necrosis when compared with low risk tumours (p value- 0.0156). Tumours of older
age group (>40 years) showed significant mitotic activity (p value 0.04). DOG1 is a very sensitive (97.8%)
marker for GIST. A wide immunopanel with emphasis on DOG 1 positivity for precise diagnosis of GIST
and classification of mes enchymal tumors of the GI tract.
Keywords: DOG 1, Mesenchymal tumours, Gastrointestinal stromal tumour, Clinicopathological, Immunohistochemical features.