An observational study of gastrointestinal stromal tumors by histopathology and immunohistochemistry

Kesarwani D, Kolte N, Kesarwani A, Jain S

Pdf Page Numbers :- 260-266

Deepika Kesarwani¹, Neelam Kolte², Amber Kesarwani^3,* and Sonali Jain⁴

¹Department of Pathology, Dr. S.L.P. Autonomous State Medical College, Pratapgarh, Uttar Pradesh 230001, India

²Department of Pathology, K.E.M. Hospital, Pune, Maharashtra 411011, India

³Department of Otolaryngology, Dr. S.L.P. Autonomous State Medical College, Pratapgarh, Uttar Pradesh 230001, India

⁴Department of Pathology, Gandhi Medical College, Bhopal, Madhya Pradesh 462001, India

*Corresponding author: Dr. Amber Kesarwani, Assistant Professor, Department of Otolaryngology, Dr. S.L.P. Autonomous State Medical College, Pratapgarh, Uttar Pradesh 230001, India. Email: dramber.kesar@gmail.com

Received 7 August 2023; Revised 16 September 2023; Accepted 20 September 2023; Published 27 September 2023

Citation: Kesarwani D, Kolte N, Kesarwani A, Jain S. An observational study of gastrointestinal stromal tumors by histopathology and immunohistochemistry. J Med Sci Res. 2023; 11(4):260-266. DOI: http://dx.doi.org/10.17727/JMSR.2023/11-48

Copyright: © 2023 Kesarwani D et al. Published by KIMS Foundation and Research Center. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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Abstract

Introduction: Gastrointestinal stromal tumors (GIST) are the most common mesenchymal neoplasms of the gastrointestinal tract and their diagnosis is mainly based on histopathology and immunohistochemical study with CD117 marker. However, there are many GIST tumors that are CD117 negative and for such cases come the role of other IHC markers. The study aimed to observe the various histological features and demographic profiles of GISTs and the role of various immunohistochemical markers in the confirmation of diagnosis.

Methodology: A hospital-based observational study was conducted on 40 tumor resection materials diagnosed as GIST from April 2017 to February 2023 at tertiary care center K.E.M. Hospital, Pune. All the cases underwent histopathological examination with standard procedure of tissue processing, staining and IHC with CD117. Those cases who were morphologically designated as GIST on HPE were evaluated with a panel of IHC markers like C-KIT, CD34, SMA, desmin, S-100 and vimentin.

Results: 35 out of 40 cases (87.5%) were found to be positive for CD117 while IHC markers like CD34, SMA, desmin, S-100 and vimentin were found to be positive in 60%, 20%, 5%, 2.5% and 80% cases respectively. Also, we found significant relationship between histopathological groups different progressive disease risk groups with necrosis, cytologic atypia, cellularity and mucosal invasion (p-value<0.05)

Conclusion: In a nutshell, a GIST diagnosis should not be precluded on the basis of morphology only. Use of immunohistochemistry is vital to rule out other mesenchymal tumors and confirmation of GIST.

Keywords: GIST; gastrointestinal stromal tumors; IHC; CD 117; histopathology; c-KIT