Popísaný je neobvyklý prípad gastrointestinálneho stromálneho tumoru (GIST) s glandulárnou zložkou. Šlo o tumor gastrického fundu u 93-ročnej ženy. Histológia lézie bola tvorená diferen- covanou vretenobunkovou štruktúrou typického GIST-u, v ktorej boli difúzne prítomné z časti cystické žliazky. Kolumnárny epitel žliazok bol podobný pylorickému a foveolárnemu typu, s lo- žiskami intestinálnej metaplázie a miestami s dyspláziami. Stromálna zložka tumoru bola imuno- histochemicky pozitívna na CD117 (c-kit) a CD34, negatívne boli myoidné a neuroidné markery. Elektronmikroskopicky šlo o nediferencované vretenovité bunky. Sliznica a submukóza v blízkos- ti tumoru vykazovali fokálne známky gastritis cystica profunda so žliazkami podobnými ako vnú- tri tumoru. V histogenéze tumoru je predpokladaná kolízia GIST-u a gastritis cystica profunda.

A case of gastrointestinal stromal tumor (GIST) with an unusual glandular component is reported. The tumor was found in the gastric fundus of a 93-year-old woman. Histologically, the lesion showed a biphasic adenosarcoma-like structure. Typical low-grade spindle cell patterns of GIST were intermingled with numerous and partly cystic glands. The glandular epithelium had pyloric/foveolar-like appearance, with foci of intestinal metaplasia and low-grade dysplasia. The stromal component was immunoreactive for CD117 (c-kit) and CD34, and negative for myoid and neuroid markers. The ultrastructural examination found nondescript and undifferentiated spindle cells. The gastric mucosa and submucosa near the tumor contained a small area with features of gastritis cystica profunda, with glands similar to those present inside the tumor. Therefore, a collision of GIST and gastritis cystica profunda is suggested in the histogenesis of the lesion.

Šikl's Department of Pathology Faculty Hospital Charles University Pilsen

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