Morphological features useful in the differential diagnosis between undifferentiated carcinoma and gastrointestinal stromal tumor
Language English Country United States Media print-electronic
Document type Journal Article
PubMed
32388398
DOI
10.1016/j.anndiagpath.2020.151527
PII: S1092-9134(20)30068-X
Knihovny.cz E-resources
- Keywords
- Differential diagnostics, GIST, Gastrointestinal stromal tumor, Sarcomatoid carcinoma, Undifferentiated carcinoma,
- MeSH
- Diagnosis, Differential MeSH
- Adult MeSH
- Gastrointestinal Neoplasms diagnosis pathology MeSH
- Gastrointestinal Stromal Tumors diagnosis pathology MeSH
- Carcinoma diagnosis pathology MeSH
- Middle Aged MeSH
- Humans MeSH
- Biomarkers, Tumor analysis MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Names of Substances
- Biomarkers, Tumor MeSH
Undifferentiated (sarcomatoid) carcinomas may closely mimic gastrointestinal stromal tumors (GISTs) due to possible histological and immunohistochemical overlap between these two entities. To avoid unnecessary employment of a wide spectrum of immunohistochemical stainings and molecular genetics and thus decrease costs, finding simple morphological features to target further investigation of such neoplasms of the gastrointestinal tract would be helpful. Five cases classified as undifferentiated (sarcomatoid) carcinomas with a definite proof of the diagnosis, i. e. the presence of a differentiated carcinomatous component, were retrieved from archives of several institutions. For comparison, 84 cases of GIST mutated in KIT or PDGFRA genes served as the control group. Hematoxylin and eosin stained slides were evaluated for the presence of patterns which might discriminate between sarcomatoid carcinoma and GIST. Lymphatic invasion and entrapment of fat tissue strongly favor the diagnosis of undifferentiated carcinoma, as it was found in all or almost all cases of undifferentiated carcinoma, but in no GIST. Alternation of low- and high- grade areas, formation of angiosarcomatous-like spaces, and the presence of yolk sac-like areas were also detected in all cases of undifferentiated carcinoma, but only in 1.2%, 2.4% and 7.2% of the GISTs, respectively. Furthermore, DOG1 was negative in all cases of undifferentiated carcinoma. According to this study, the presence of the histological findings listed above should prompt extensive tumor sampling in order to find a differentiated carcinomatous component. However, due to the small number of cases of undifferentiated carcinoma available for the study, a larger multi-institutional study is warranted.
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