Gastrointestinal stromal tumor differential diagnosis

Gastrointestinal stromal tumor Microchapters
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Akshun Kalia M.B.B.S.[2]Parminder Dhingra, M.D. [3]

Overview

Gastrointestinal stromal tumor must be differentiated from other gastrointestinal leiomyoma, gastrointestinal leiomyosarcoma, gastrointestinal lymphoma / gastric lymphoma, gastrointestinal schwannoma and gastrointestinal carcinoid.

Differential Diagnosis

• Gastrointestinal leiomyoma:

• Most common in the esophagus, accounting for 75% of mesenchymal tumours
• Rare in the remainder of the gastrointestinal tract

• Gastrointestinal leiomyosarcoma: rare
• Gastrointestinal lymphoma / gastric lymphoma
• Gastrointestinal schwannoma
• Gastrointestinal carcinoid

Marker	GIST	GI leiomyoma	GI Leiomyosarcoma	Schwannoma	GI carcinoma	Melanoma
CD117	Positive (95%)	Negative	Negative	Negative	Positive (50%)	Positive
CD34	Positive (70%)	Negative	Negative	Positive (33%)	Negative	negative
DOG 1	Positive (95%)	Negative	Negative	Negative	Negative	Rare
Other Markers	Desmin positive in 1-2%	Desmin positive in 100% cases	Desmin positive but variable proportion	GFAP positive	Keratin positive	S100 positive