Presentation
Abdominal pain for investigation. Incidental finding on gastroscopy - now resection.
Patient Data
Age: 55 years
Gender: Male
From the case:
Gastrointestinal stromal tumor (GIST) - gastric (pathology)
Gross pathology
Macro (distal gastrectomy specimen): There is a solid and partly cystic/hemorrhagic lesion in the gastric wall, with intact and relatively normal overlying gastric mucosa. The lesion extends to but does not appear to breach the serosa.
From the case:
Gastrointestinal stromal tumor (GIST) - gastric (pathology)
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H&E
Microscopic features;
- 'spindle cell' pattern
- cells arranged in whorls and irregular fascicles
- cells have spindled to elongate nuclei (these tumors can be 'epithelioid')
- positive staining for c-Kit
- important microscopic prognostic features include;
- low mitotic activity (we give a count of number of mitoses/50 high power fields [x400])
- no necrosis
- uniform low cellularity
- minimal pleomorphism
Case Discussion
The important prognostic features in this case include;
- location (gastric)
- size (55mm)
- mitotic activity (up to 2 per 50 hpf)
Using published data (see reference below), this case has a 'low' risk of progessive disease.
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