Gastrointestinal stromal tumor pathophysiology: Difference between revisions
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==Pathophysiology== | ==Pathophysiology== | ||
*GISTs are thought to arise from [[interstitial cells of Cajal]] (ICC), that are normally part of the [[autonomic nervous system]] of the intestine. They serve a pacemaker function in controlling [[motility]].<ref name=miettinen>{{cite journal |author=Miettinen M, Lasota J |title=Gastrointestinal stromal tumors: review on morphology, molecular pathology, prognosis, and differential diagnosis |journal=Arch Pathol Lab Med |volume=130 |issue=10 |pages=1466-78 |year=2006 |id=PMID 17090188}}</ref> | *GIST can occur in any part of the gastrointestinal tract but the most common location is stomach with the second most common location as small intestine. Less frequent sites of occurrence include the colon, rectum and esophagus. Rare sites include pancreas, omentum, or mesentery. | ||
*GIST can arises from the submucosal layer or the smooth muscle cells of the GI tract. | |||
*GIST tumors can either be benign or malignant. They can be any size. GIST can grow as an endophytic or exophytic lesions. | |||
**Endophytic lesions are linear lesions that grow along the lumen of the affected organ. | |||
**Exophytic lesions can present as a protruding outgrowth outside the lumen of GI tract. | |||
*GISTs are thought to arise from [[interstitial cells of Cajal]] (ICC), that are normally part of the [[autonomic nervous system]] of the intestine. They serve a pacemaker function in controlling [[motility]].<ref name="miettinen">{{cite journal |author=Miettinen M, Lasota J |title=Gastrointestinal stromal tumors: review on morphology, molecular pathology, prognosis, and differential diagnosis |journal=Arch Pathol Lab Med |volume=130 |issue=10 |pages=1466-78 |year=2006 |id=PMID 17090188}}</ref> | |||
*GISTs are believed to arise from the interstitial cells of Cajal, with 95% staining positive for CD117 (c-KIT) and 70% for CD34. The former is a tyrosine kinase growth factor receptor and the target of ST-571 (Imatinib; Glivec). | *GISTs are believed to arise from the interstitial cells of Cajal, with 95% staining positive for CD117 (c-KIT) and 70% for CD34. The former is a tyrosine kinase growth factor receptor and the target of ST-571 (Imatinib; Glivec). | ||
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*Histology demonstrates a relatively cellular [[tumor]] comprised of spindle cells (70-80%) and or plump epithelioid cells (20-30%). They appear to arise from the muscularis propria layer.<ref>{{Cite web | title = Gastrointestinal stromal tumour| url = http://radiopaedia.org/articles/gastrointestinal-stromal-tumour-1}}</ref> | *Histology demonstrates a relatively cellular [[tumor]] comprised of spindle cells (70-80%) and or plump epithelioid cells (20-30%). They appear to arise from the muscularis propria layer.<ref>{{Cite web | title = Gastrointestinal stromal tumour| url = http://radiopaedia.org/articles/gastrointestinal-stromal-tumour-1}}</ref> | ||
[[Image:gist.jpg|thumb|left|Gastrointestinal stromal tumor of stomach. Courtesy of Ed Uthman, MD.]] | [[Image:gist.jpg|thumb|left|Gastrointestinal stromal tumor of stomach. Courtesy of Ed Uthman, MD.]] | ||
<br clear="left"/> | <br clear="left" /> | ||
[[Image:GIST 2.jpg|left|thumb|200px|[[Endoscopy|Endoscopic]] image of GIST in fundus of [[stomach]], seen on retroflexion.]] | [[Image:GIST 2.jpg|left|thumb|200px|[[Endoscopy|Endoscopic]] image of GIST in fundus of [[stomach]], seen on retroflexion.]] | ||
<br clear="left"/> | <br clear="left" /> | ||
[[Image:GIST 3.jpg|left|thumb|200px|Same GIST seen on forward view of the endoscope showing overlying clot.]] | [[Image:GIST 3.jpg|left|thumb|200px|Same GIST seen on forward view of the endoscope showing overlying clot.]] | ||
<br clear="left"/> | <br clear="left" /> | ||
==References== | ==References== | ||
Revision as of 16:56, 29 November 2017
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Gastrointestinal stromal tumor Microchapters |
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Differentiating Gastrointestinal stromal tumor from other Diseases |
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Diagnosis |
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Treatment |
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Case Studies |
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Gastrointestinal stromal tumor pathophysiology On the Web |
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American Roentgen Ray Society Images of Gastrointestinal stromal tumor pathophysiology |
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Directions to Hospitals Treating Gastrointestinal stromal tumor |
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Risk calculators and risk factors for Gastrointestinal stromal tumor pathophysiology |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Parminder Dhingra, M.D. [2]
Overview
On microscopic histopathological analysis, spindle cells or plump epithelioid cells are characteristic findings of gastrointestinal stromal tumor.
Pathophysiology
- GIST can occur in any part of the gastrointestinal tract but the most common location is stomach with the second most common location as small intestine. Less frequent sites of occurrence include the colon, rectum and esophagus. Rare sites include pancreas, omentum, or mesentery.
- GIST can arises from the submucosal layer or the smooth muscle cells of the GI tract.
- GIST tumors can either be benign or malignant. They can be any size. GIST can grow as an endophytic or exophytic lesions.
- Endophytic lesions are linear lesions that grow along the lumen of the affected organ.
- Exophytic lesions can present as a protruding outgrowth outside the lumen of GI tract.
- GISTs are thought to arise from interstitial cells of Cajal (ICC), that are normally part of the autonomic nervous system of the intestine. They serve a pacemaker function in controlling motility.[1]
- GISTs are believed to arise from the interstitial cells of Cajal, with 95% staining positive for CD117 (c-KIT) and 70% for CD34. The former is a tyrosine kinase growth factor receptor and the target of ST-571 (Imatinib; Glivec).
- Macroscopically these tumours are rounded with frequent haemorrhagic change. Larger tumours also may demonstrate necrosis and cystic change. Size is variable ranging form 1 to 30cm.
- Histology demonstrates a relatively cellular tumor comprised of spindle cells (70-80%) and or plump epithelioid cells (20-30%). They appear to arise from the muscularis propria layer.[2]
References
- ↑ Miettinen M, Lasota J (2006). "Gastrointestinal stromal tumors: review on morphology, molecular pathology, prognosis, and differential diagnosis". Arch Pathol Lab Med. 130 (10): 1466–78. PMID 17090188.
- ↑ "Gastrointestinal stromal tumour".