A limited immunocytochemical panel for the distinction of subepithelial gastrointestinal mesenchymal neoplasms sampled by endoscopic ultrasound-guided fine-needle aspiration

Edward B. Stelow, Faris M. Murad, Steven M. Debol, Michael W. Stanley, Ricardo H. Bardales, Rebecca Lai, Shawn Mallery

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36 Scopus citations

Abstract

We studied the use of immunocytochemical analysis with material procured by endoscopic ultrasound-guided fine-needle aspiration (EUS-guided FNA) for the diagnosis of subepithelial intramural gastrointestinal (GI) mesenchymal neoplasms (SIGIMNs). We identified all EUS-guided FNA specimens of SIGIMNs that had undergone immunocytochemical analysis. Results were compared with follow-up histologic diagnoses. There were 95 aspirates that were diagnosed as GI mesenchymal tumors (GI stromal tumors [GISTs], n = 46), leiomyomas (n = 38), peripheral nerve sheath tumors (n = 5), and other neoplasms by cytologic examination. Immunoreactivity with antibodies to CD117 always predicted GIST at follow-up; 15 of 16 cases immunoreactive with antibodies to CD34 were found to be GISTs at follow-up. Strong immunoreactivity with antibodies to smooth muscle actin or desmin usually predicted a leiomyoma at follow-up aside from a single glomus tumor and a case with apparent nonneoplastic smooth muscle contaminant. When sufficient material is present, immunocytochemical analysis used with material obtained by EUS-guided FNA is highly predictive of final pathologic diagnosis.

Original languageEnglish (US)
Pages (from-to)219-225
Number of pages7
JournalAmerican journal of clinical pathology
Volume129
Issue number2
DOIs
StatePublished - Feb 2008

Keywords

  • Endoscopic ultrasound
  • Fine-needle aspiration
  • Gastrointestinal stromal tumor
  • Glomus tumor
  • Granular cell tumor
  • Immunocytochemistry
  • Leiomyoma
  • Schwannoma

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