위장관 간엽성 종양: 53예의 임상병리학적 고찰
A Clinicopathologic Study of 53 Gastrointestinal Mesenchymal Tumors
배영경, 김동석, 구미진, 최준혁, 김미진, 김용진, 최원희, 송선교, 권굉보,
소속 상세정보
배영경 ( Bae Young-Kyung )
영남대학교 의과대학 병리학교실
김동석 ( Kim Dong-Sug )
영남대학교 의과대학 병리학교실
구미진 ( Gu Mi-Jin )
영남대학교 의과대학 병리학교실
최준혁 ( Choi Joon-Hyuk )
영남대학교 의과대학 병리학교실
김미진 ( Kim Mi-Jin )
영남대학교 의과대학 병리학교실
김용진 ( Kim Yong-Jin )
영남대학교 의과대학 병리학교실
최원희 ( Choi Won-Hee )
영남대학교 의과대학 병리학교실
송선교 ( Song Sun-Kyo )
영남대학교 의과대학 외과학교실
권굉보 ( Kwan Koing-Bo )
영남대학교 의과대학 외과학교실
KMID : 0357920000340110909
Abstract
The gastrointestinal mesenchymal tumors (GIMTs) form a heterogenous group with controversy centering on both the cell of origin and the prediction of clinical behavior. They include a small group of tumors with mature smooth muscle or Schwann cell differentiation and a larger group with inconsistent or no evidence of differentiation. Tumors in the latter are now referred to as gastrointestinal stromal tumors (GISTs). A clinicopathologic and immunohistochemical study was performed on 53 cases of GIMTs to identify cellular differentiation and predictors of clinical behavior. Fifty three cases of GIMTs could be histologically and immunophenotypically divided into three categories, 6 leiomyomas (11.3%), 4 schwannomas (7.6%), and 43 GISTs (81.1%). All leiomyomas (SMA desmin ) and schwannomas (S-100 ) were located in stomach and negative for CD34 and CD117. Thirty nine cases of GISTs were either CD34 (n=26) or CD117 (n=23) immunoreactive. Of these 39 GISTs, 26 were negative for myoid (SMA, desmin) and neural marker (S-100), 10 SMA desmin-S-100-, two SMA-desmin-S-100 , and one SMA desmin-S-100 . Two out of 4 GISTs, which were negative for CD34 and CD117, were immunohistochemically considered leiomyosarcoma (SMA desmin ). GISTs of small intestine had a tendency to be malignant than those of stomach. Pathologic grade of GISTs was not correlated with cellular differentiation. In 29 GISTs with clinical follow-up information, tumor size, mitotic counts, Ki-67 labelling index, tumor necrosis, mucosal invasion, and CD34 expression were significantly correlated with metastasis/recurrence.
키워드
Gastrointestinal mesenchymal tumor;Gastrointestinal stromal tumor;Leiomyoma;Schwannoma
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