Subclassification of gastrointestinal stromal tumors based on evaluation by electron microscopy and immunohistochemistry Journal Article
| Authors: | Erlandson, R. A.; Klimstra, D. S.; Woodruff, J. M. |
| Article Title: | Subclassification of gastrointestinal stromal tumors based on evaluation by electron microscopy and immunohistochemistry |
| Abstract: | Fifty-six gastrointestinal stromal tumors (GIST) were subclassified by ultrastructural examination and by immunophenotypic analysis using a panel of 13 antibodies. Eighty percent of the tumors originated in the stomach and small intestines. The neoplasms were classified as follows: 42.9% smooth muscle tumors (4 leiomyomas, 9 spindle cell and 6 epithelioid leiomyosarcomas, and 3 mixed spindle cell and epithelioid leiomyosarcomas); 37.5% gastrointestinal autonomic nerve tumors (GANT), 47.6% of which arose in the small intestines; 8.9% mixed leiomyosarcoma/neurogenic tumors; and 10.7% undifferentiated GIST, not otherwise specified. The muscle common actin antibody HHF-35, variably reactive with tumor cells composing 23 of 24 smooth muscle tumors, was found to be the most sensitive marker of leiomyocyte differentiation. One immunophenotypically questionable spindle cell leiomyosarcoma was diagnosed by electron microscopy. Since neuron specific enolase positive cells were found in 1/3 of the leiomyosarcoma cases, the ultrastructural demonstration of synapse-like structures and neurosecretory granules was required for diagnosing GANTs. The immunophenotype of the ultrastructurally undifferentiated GIST was vimentin and CD34+. Variable numbers of ultrastructurally undifferentiated cells also were found in all of the tumors except 2 leiomyomas. CD34 was also expressed in smooth muscle (64%) and GAN (62%) tumors. Despite their similar light microscopic appearance, GIST are phenotypically heterogeneous, requiring both ultrastructural and immunohistochemical studies for accurate characterization. |
| Keywords: | immunohistochemistry; adult; controlled study; human tissue; aged; middle aged; major clinical study; protein localization; biological markers; electron microscopy; microscopy, electron; gastrointestinal stromal tumor; cd34 antigen; gastrointestinal neoplasms; immunophenotyping; leiomyosarcoma; spindle cell carcinoma; tumor classification; neoplasms, nerve tissue; neuron specific enolase; vimentin; neoplasms, muscle tissue; gastrointestinal tumor; smooth muscle tumor; leiomyoma; cell ultrastructure; humans; human; male; female; priority journal; article; actin antibody; autonomic nerve tumor |
| Journal Title: | Ultrastructural Pathology |
| Volume: | 20 |
| Issue: | 4 |
| ISSN: | 0191-3123 |
| Publisher: | Informa Healthcare |
| Date Published: | 1996-01-01 |
| Start Page: | 373 |
| End Page: | 393 |
| Language: | English |
| PUBMED: | 8837346 |
| PROVIDER: | scopus |
| DOI: | 10.3109/01913129609016340 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 22 November 2017 -- Source: Scopus |
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