Oncology Medical News about GI stromal tumors;divergent molecular cytogenetic progression;histomorphological pattern

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Distinct biphasic histomorphological pattern in gastrointestinal stromal tumours (GISTs) with common primary mutations but divergent molecular cytogenetic progression
Histopathology, 03/11/09

Agaimy A et al. - In a study to shed light on molecular pathogenesis of gastrointestinal stromal tumours (GISTs) displaying a distinct biphasic histomorphological pattern, it was concluded that intratumoral phenotypic diversity in GISTs reflects histomorphological progression, which is associated with higher chromosomal instability, irrespective of primary mutation.

Methods

6 biphasic gastric GISTs (4 high, 1 intermediate and 1 low risk for aggressive behaviour) were studied by histological, immunohistochemical, molecular and comparative genomic hybridization methods.
Different tumour components were designated as primary and secondary compartments, based on cellularity and mitotic index.
Metastases from 2 pts were analysed separately.
4 biphasic histomorphological patterns were seen: sclerosing spindle cell/dyscohesive or paraganglioma-like epithelioid (n=2); sarcomatous spindle cell/pleomorphic sarcomatous spindle cell (n=1); sarcomatous spindle cell/sarcomatous epithelioid (n=2); and sclerosing epithelioid/hypercellular epithelioid/sarcomatous epithelioid (n=1) morphology.

Results

In each case, both tumour compartments revealed the same KIT (n=5) or platelet-derived growth factor receptor-alpha (n=1) mutation, as well as common chromosomal imbalances reflecting their common clonal origin.
Additional chromosomal imbalances were detected in secondary tumour compartments and their respective metastases.

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