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KMID : 0352119920080030219
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Journal of Kyung Hee University
1992 Volume.8 No. 3 p.219 ~ p.234
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Histopathological and Immunohistochemical Study on Gastrointestinal Stromal Tumors
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Abstract
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To evaluate clinicopathologic characteristics and histogenesis of the gastrointestinal stromal tumors, we had performed an immunohistochemical study and histopathological reexamination in 53 cases diagnosed as stromal tumors of gastrointestinal
tract
during 11 years from 1981 to 1991.
The location of tumors were the stomach in 32 cases, the small intestine in 16 cases and the large intestine in 11 cases, and the average diameter of tumor was 7.3±4.11 cm. The gastrointestinal stromal tumors appeared as an extraluminal mass in
24
cases, an intraluminal mass in 19 cases, dumbbell-shaped mass in 7 cases, and an intramural mass in 3 cases. Each tumor was composed of spindle or epithelioid cells, the former type being more common than the latter (47 vs 6 cases). The criteria
for
malignancy applied in this study were one of the followings; 1) 5 or more mitoses/10 HPF or 2) 1-4 mitoses/10 HPF with tumor necrosis, 10 cm or greater in tumor size and marked cellular pleomorphism. The tumors having high cellularity and/or
tumor
necrosis, but fewer than 5 mitoses per ten HPF were categorized as smooth muscle tumors of undeterminate malignant potential (STUMP). The tumors were classified as benign in 28 cases, STUMP in 4 cases, and malignant in 21 cases.
Immunohistochemically, 51 cases (94.3%) of tumor expressed vimentin immunoreactivity, 12 cases (22.6%) expressed actin, 6 cases (11.3%) having S-100 protein, 2 cases were positive for desmin, but no tumors revealed detectable lysozyme. Although
the
histogenesis of gastrointestinal stromal tumors remains controversial, we would like to conclude that gastrointestinal stromal tumors would be smooth muscle origin on account of their morphological characteristics and their intramural location,
but
most
of them seemed to be originated from undifferentiated or multipotential mesenchymal cells by immunohistochemical methods.
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KEYWORD
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