Gastrointestinal stromal tumours (GIST)

• GIST is also called as leimyoma, leimyosarcoma.
• In GIT, stomach is the commonest site of GIST.

Pathogenesis- 

• They are tumour of mesenchymal origin.
• It arises from the intestinal cells of Cajal or pacemaker cells.
• Prognosis depends on size.
• Histology shows spindle shaped cells
• Associated with NF 1

Clinical features-

• Bleeding is the common feature (endoscopy appearance of cervix)
• Carney triad- Gastric GIST, paraganglioma, pulmonary chondroma.
• Dysphagia, weight loss, anaemia.

Investigations–

• Diagnosis of malignancy is by greater mitotic figures.
• Immunohistochemistry is mandatory for diagnosis C- kit gene amplification tumour marker (CD 117).
• CT scan
• Size & mitotic index are the best predictors of metastasis.
• Biopsy

Treatment-

• Resection
• Chemotherapy- Cap. Imatinib (100mg 4 capsules)

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