Gastrointestinal tract spindle cell tumors with interstitial cells of Cajal: Prevalence excluding gastrointestinal stromal tumors

Lee,So Jung; Hwang,Chung Su; Kim,Ahrong; Kim,Kyungbin; Choi,Kyung Un

doi:10.3892/ol.2016.4758

August-2016 Volume 12 Issue 2

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August-2016 Volume 12 Issue 2

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Article Open Access

Gastrointestinal tract spindle cell tumors with interstitial cells of Cajal: Prevalence excluding gastrointestinal stromal tumors

Authors:
- So Jung Lee
- Chung Su Hwang
- Ahrong Kim
- Kyungbin Kim
- Kyung Un Choi
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Affiliations: Department of Pathology, Pusan National University Hospital, Busan 49241, Republic of Korea, Department of Pathology, Pusan National University Yangsan Hospital, Yangsan, Gyeongsangnam 50612, Republic of Korea, Department of Pathology, Ulsan University Hospital, Ulsan 44033, Republic of Korea

Copyright: © Lee et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
Pages: 1287-1292
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Published online on: June 22, 2016

https://doi.org/10.3892/ol.2016.4758
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Abstract

Leiomyomas and schwannomas of the gastrointestinal tract (GIT) are mainly comprised of spindle‑shaped tumor cells and should always be differentiated from gastrointestinal stromal tumors (GISTs). Mast/stem cell growth factor receptor Kit (KIT) and discovered on GIST-1 (DOG1) are well‑known diagnostic markers for the detection of a GIST by immunohistochemical staining. The aim of the present study was to assess the prevalence and significance of spindle cell tumors of the GIT with KIT‑ or DOG1‑positive spindle‑shaped cells, presumed to be interstitial cells of Cajal (ICCs), other than GISTs. A total of 71 leiomyomas and 35 schwannomas were examined and clinicopathological information was obtained. KIT and DOG1 immunostaining was performed to determine the proportions of positive cells. Mutation screening of KIT exons 9, 11, 13 and 17, and platelet‑derived growth factor receptor α (PDGFRA) exons 12 and 18 was performed in cases with a relatively high proportion of either KIT‑ or DOG1‑positive cells. The frequency of leiomyomas and schwannomas with KIT‑ and DOG1‑positive ICCs was 35.2% (25/71 cases) and 5.7% (2/35 cases), respectively. Among the esophageal leiomyomas with KIT‑ and DOG‑positive ICCs (14/25; 56.0%), 5 leiomyomas involved the muscularis mucosa and 9 leiomyomas involved the muscularis propria. All gastric leiomyomas with KIT‑ and DOG1‑positive ICCs (11/25; 44%) involved the muscularis propria. All schwannomas with an increased proportion of KIT‑ or DOG1‑positive ICCs were of gastric origin. No KIT or PDGFRA mutations were detected in 7 leiomyomas and 2 schwannomas. In conclusion, the majority of leiomyomas and the minority of schwannomas in the GIT had a significant portion of KIT‑ and DOG1‑positive cells. All of the tumors were located in the upper GIT, and could be present in the muscularis propria or muscularis mucosa. The tumors represented a non‑neoplastic proliferation of KIT‑ and DOG1‑positive cells in the GIT. Careful evaluation of KIT‑ or DOG1‑positive cells in spindle cell tumors of the GIT can assist in forming the correct diagnosis by differentiation from a GIST.

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1	Miettinen M, Sarlomo-Rikala M and Sobin LH: Mesenchymal tumors of muscularis mucosae of colon and rectum are benign leiomyomas that should be separated from gastrointestinal stromal tumors - A clinicopathologic and immunohistochemical study of eighty-eight cases. Mod Pathol. 14:950–956. 2001. View Article : Google Scholar : PubMed/NCBI
2	Rosai J: Gastrointestinal stromal tumor and its mimics. Int J Surg Pathol. 18(3 Suppl): S79–S87. 2010. View Article : Google Scholar
3	Kindblom LG, Remotti HE, Aldenborg F and Meis-Kindblom JM: Gastrointestinal pacemaker cell tumor (GIPACT): Gastrointestinal stromal tumors show phenotypic characteristics of the interstitial cells of Cajal. Am J Pathol. 152:1259–1269. 1998.PubMed/NCBI
4	Miettinen M, Wang ZF and Lasota J: DOG1 antibody in the differential diagnosis of gastrointestinal stromal tumors: A study of 1840 cases. Am J Surg Pathol. 33:1401–1408. 2009. View Article : Google Scholar : PubMed/NCBI
5	Miettinen M, Sobin LH and Lasota J: Gastrointestinal stromal tumors of the stomach: A clinicopathologic, immunohistochemical, and molecular genetic study of 1765 cases with long-term follow-up. Am J Surg Pathol. 29:52–68. 2005. View Article : Google Scholar : PubMed/NCBI
6	Miettinen M and Lasota J: Gastrointestinal stromal tumors-definition, clinical, histological, immunohistochemical, and molecular genetic features and differential diagnosis. Virchows Arch. 438:1–12. 2001. View Article : Google Scholar : PubMed/NCBI
7	West RB, Corless CL, Chen X, Rubin BP, Subramanian S, Montgomery K, Zhu S, Ball CA, Nielsen TO, Patel R, et al: The novel marker, DOG1, is expressed ubiquitously in gastrointestinal stromal tumors irrespective of KIT or PDGFRA mutation status. Am J Pathol. 165:107–113. 2004. View Article : Google Scholar : PubMed/NCBI
8	Kim JM, Kim A, Choi JH and Bae YK: Usefulness of DOG1 expression in the diagnosis of gastrointestinal stromal tumors. Korean J Pathol. 44:141–148. 2010. View Article : Google Scholar
9	Deshpande A, Nelson D, Corless CL, Deshpande V and O'Brien MJ: Leiomyoma of the gastrointestinal tract with interstitial cells of Cajal: A mimic of gastrointestinal stromal tumor. Am J Surg Pathol. 38:72–77. 2014. View Article : Google Scholar : PubMed/NCBI
10	Miettinen M, Sarlomo-Rikala M, Sobin LH and Lasota J: Esophageal stromal tumors: A clinicopathologic, immunohistochemical, and molecular genetic study of 17 cases and comparison with esophageal leiomyomas and leiomyosarcomas. Am J Surg Pathol. 24:211–222. 2000. View Article : Google Scholar : PubMed/NCBI
11	Hou YY, Tan YS, Xu JF, Wang XN, Lu SH, Ji Y, Wang J and Zhu XZ: Schwannoma of the gastrointestinal tract: A clinicopathological, immunohistochemical and ultrastructural study of 33 cases. Histopathology. 48:536–545. 2006. View Article : Google Scholar : PubMed/NCBI

Journals

International Journal of Molecular Medicine

International Journal of Oncology

Molecular Medicine Reports

Oncology Reports

Experimental and Therapeutic Medicine

Oncology Letters

Biomedical Reports

Molecular and Clinical Oncology

World Academy of Sciences Journal

International Journal of Functional Nutrition

International Journal of Epigenetics

Medicine International

Gastrointestinal tract spindle cell tumors with interstitial cells of Cajal: Prevalence excluding gastrointestinal stromal tumors

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Abstract

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