Journal article
Gastrointestinal stromal tumors (GISTs) arising in uncommon locations: clinicopathologic features and risk assessment of esophageal, colonic, and appendiceal GISTs
Modern pathology, Vol.35, pp.554-563
10/26/2021
DOI: 10.1038/s41379-021-00949-w
PMID: 34702994
Abstract
Risk stratification of gastrointestinal stromal tumors (GISTs) is based on experience with tumors of the stomach, small bowel, and rectum, which are far more common than GISTs of other sites. In this study from 47 institutions, we analyzed GISTs of the esophagus (n = 102), colon (n = 136), and appendix (n = 27) for their size, mitotic rate, morphology, and outcome to determine which criteria predict their behavior. Esophageal GISTs were small (median: 2.5 cm) with spindle cell morphology and a low mitotic rate (mean: 3.6/5 mm2). Twelve (12%) tumors progressed, including 11 with a mitotic rate >5/5 mm2 and one large (6.8 cm) GIST with a mitotic rate of 2/5 mm2. Colonic GISTs were smaller (median: 1.4 cm) and presented with abdominal pain or bleeding in 29% of cases. Most (92%) were composed of spindle cells with a mean mitotic rate of 4.6/5 mm2. Sixteen (12%) tumors progressed: 14 had mitotic rates >5/5 mm2, and two were >5.0 cm with a mitotic rate <5/5 mm2. All but one appendiceal GIST measured <2.0 cm. These tumors were composed of spindle cells with low mitotic rates (<5/5 mm2), and none progressed. Our results suggest that progression risk among esophageal and colonic GISTs is associated with increased mitotic activity (>5/5 mm2) and size >5.0 cm. These findings support the use of size and mitotic rate for prognostication of GISTs in these locations, similar to tumors of the stomach, small bowel, and rectum.
© 2021. The Author(s), under exclusive licence to United States & Canadian Academy of Pathology.
Details
- Title: Subtitle
- Gastrointestinal stromal tumors (GISTs) arising in uncommon locations: clinicopathologic features and risk assessment of esophageal, colonic, and appendiceal GISTs
- Creators
- Shaomin Hu - Cleveland ClinicLindsay Alpert - University of ChicagoJustin M. M Cates - Vanderbilt University Medical CenterRaul S Gonzalez - Beth Israel Deaconess Medical CenterRondell GrahamJohn R GoldblumAhmed BakhshwinSindhu ShettyHanlin L WangTrang LollieChangqing MaAyesha SiddiqueDipti M KaramchandaniFengming ChenRhonda K YantissErika HissongDeyali ChatterjeeShefali ChopraWei ChenJennifer VazzanoWei-Lien WangDi AiJingmei LinLan ZhengJessica L DavisBrian BrinkerhoffAmanda BreitbarthMichelle YangSepideh MadahianNicole PanarelliKevin KuanJonathan PomperTeri LongacreShyam RaghavanJoseph MisdrajiMin CuiZhaohai YangDeepika SavantNoam HarpazXiuxu ChenMurray ResnickElizabeth Yiru WuDavid KlimstraJinru ShiaMonika VyasSanjay KakarWon-Tak ChoiMarie E RobertHongjie LiMichael LeeIan ClarkYongchao LiWenqing CaoQing ChangMary P BronnerZachary DongWei ZhangDarya BuehlerPaul E SwansonJose G MantillaAndrew M BellizziMichael FeelyHarry S CooperRajeswari NagarathinamRish PaiSuntrea HammerMojgan HosseiniJingJing HuMaria WesterhoffJerome ChengDiana Agostini-VulajGregory LauwersMasoumeh GhayouriMaryam K PezhouhJianying ZengRong XiaFeng YinTao ZhangZu-hua GaoNadine DemkoHannah H ChenSanhong YuJohn Hart
- Contributors
- Rare GIST Risk Stratification Group (Author)
- Resource Type
- Journal article
- Publication Details
- Modern pathology, Vol.35, pp.554-563
- DOI
- 10.1038/s41379-021-00949-w
- PMID
- 34702994
- NLM abbreviation
- Mod Pathol
- ISSN
- 0893-3952
- eISSN
- 1530-0285
- Language
- English
- Date published
- 10/26/2021
- Academic Unit
- Pathology
- Record Identifier
- 9984200022202771
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