Acta Medica Medianae
Vol. 49, No 3, September, 2010
UDK 61
ISSN 0365-4478(Printed version)
ISSN 1821-2794(Online)
 

Correspondence to:

Vuka Katić

Bulevar Nemanjića 74/13

18000 Niš, Srbija

E-mail: vuka.katic@gmail.com

Professional article
UDC:  616.33-006-091.8

MORPHOLOGICAL AND IMMUNOCYTOCHEMICAL CHARACTERISTICS OF STROMAL GASTROINTESTINAL TUMORS

Vuka Katić¹, Boris Đinđić², Vesna Živković³, Danica Marković⁴, Bojana Marković- Živković⁴, Ivan Ilić³ and Dušan Mihajlović4

                       Retired Professor of Pathology¹

                       Institute of Pathologic Physiology, Faculty of Medicine University of Niš²

                       Institute of Pathology, Faculty of Medicine University of Niš³

                       Faculty of Medicine University of Niš⁴

Gastrointestinal stromal tumors (GIST) are the most frequent mesenchymal tumors of gastrointestinal system and they are characterised by extreme variability in clinical, hystopathological and genetic features. It is considered that all GISToms have a malignant potential. Ethiological factors which cause GISToms have not been clarified yet, and genetic basis is not easy to be determined since GISToms are mostly sporadic. However, certain genetic and cytogenetic aberations which have been determined can be considered to have an impact on the onset of GISToms. Macroscopic picture is polymorphic, but they can most frequently be seen as large, mushroom-like, intraluminal, clearly limited pseudo-incapsulated submucosal masses. Hystomorphology of these tumors shows a high spectar of structural and cellular variations. They are most frequently built out of spindle cells (60-70% of cases), rarely of epitheloid (about 30% of cases) and very rarely of mixed and transitional type (intermedial). Stroma is predominantly loose or poorly colagenized with neoangiogenesis, which is markedly in GISToms with a higher malignant potential. Most of GISToms (95%) express transmembrane receptors KIT (CD 117), CD 34, vimentine, specific neurogenic and smooth muscle cells markers. The most successful therapies are: surgical ressection, imatinib and sunitinib (in case of imatinib resistence) therapy (tyrosine kinase receptor blockers). Research are being conducted all over the world with the aim of finding new and more efficient drug therapies that would not manifest resistency. Acta Medica Medianae 2010;49(3):58-64.

Key words: gastrointestinal stromal tumors, GIST, c-kit protein, imatinib, morphology