Gastrointestinal stromal tumor in the duodenum exhibiting hemangiopericytoma-like histological pattern

Pathol Int. 2009 Feb;59(2):98-101. doi: 10.1111/j.1440-1827.2008.02335.x.

Abstract

Reported herein is a gastrointestinal stromal tumor (GIST) that exhibited a hemangiopericytoma (HPC)-like histological pattern. Such a morphological variant of GIST has not been described previously. A 57-year-old woman presented with bloody stools. On upper digestive tract endoscopy a submucosal tumor of diameter 2 cm was detected at the duodenal bulb, and enucleated. Grossly, the tumor was well-circumscribed, grayish to whitish, and solid, and its central portion was ulcerated. Histology indicated round to fusiform tumor cells that had proliferated around branching vessels that had a staghorn configuration. Immunohistochemistry showed that the tumor cells were diffusely positive for vimentin and KIT; partially positive for CD34 and muscle actin; and negative for alpha-smooth muscle actin. On mutation analysis a 42 bp deletion was found from codons 560 to 573 of exon 11 of the KIT gene, which is a mutational hot spot of GIST. In diagnosis of gastrointestinal tract tumors with an HPC-like histological pattern, pathologists should consider the possibility of GIST.

Publication types

  • Case Reports

MeSH terms

  • Biomarkers, Tumor / analysis
  • DNA Mutational Analysis
  • DNA, Neoplasm / analysis
  • Duodenal Neoplasms / chemistry
  • Duodenal Neoplasms / genetics
  • Duodenal Neoplasms / pathology*
  • Female
  • Gastrointestinal Stromal Tumors / chemistry
  • Gastrointestinal Stromal Tumors / genetics
  • Gastrointestinal Stromal Tumors / pathology*
  • Gene Deletion
  • Hemangiopericytoma / pathology*
  • Humans
  • Middle Aged
  • Proto-Oncogene Proteins c-kit / analysis
  • Proto-Oncogene Proteins c-kit / genetics
  • Vimentin / analysis

Substances

  • Biomarkers, Tumor
  • DNA, Neoplasm
  • Vimentin
  • Proto-Oncogene Proteins c-kit