Gastrointestinal stromal tumours

Gastrointestinal stromal tumours


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)

Exam Important

  • 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.

Investigations

  • Immunohistochemistry is mandatory for diagnosis C- kit gene amplification tumour marker (CD 117).

Treatment-

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