A limited immunocytochemical panel for the distinction of subepithelial gastrointestinal mesenchymal neoplasms sampled by endoscopic ultrasound-guided fine-needle aspiration.

Abstract

We studied the use of immunocytochemical analysis with material procured by endoscopic ultrasound-guided fine-needle aspiration (EUS-guided FNA) for the diagnosis of subepithelial intramural gastrointestinal (GI) mesenchymal neoplasms (SIGIMNs). We identified all EUS-guided FNA specimens of SIGIMNs that had undergone immunocytochemical analysis. Results were compared with follow-up histologic diagnoses. There were 95 aspirates that were diagnosed as GI mesenchymal tumors (GI stromal tumors [GISTs], n = 46), leiomyomas (n = 38), peripheral nerve sheath tumors (n = 5), and other neoplasms by cytologic examination. Immunoreactivity with antibodies to CD117 always predicted GIST at follow-up; 15 of 16 cases immunoreactive with antibodies to CD34 were found to be GISTs at follow-up. Strong immunoreactivity with antibodies to smooth muscle actin or desmin usually predicted a leiomyoma at follow-up aside from a single glomus tumor and a case with apparent nonneoplastic smooth muscle contaminant. When sufficient material is present, immunocytochemical analysis used with material obtained by EUS-guided FNA is highly predictive of final pathologic diagnosis.

• Authors: Edward B Stelow, Faris M Murad, Steven M Debol, Michael W Stanley, Ricardo H Bardales, Rebecca Lai, Shawn Mallery
• Journal: American journal of clinical pathology (Am J Clin Pathol) Vol. 129 Issue 2 Pg. 219-25 (Feb 2008) ISSN: 0002-9173 [Print] England
• PMID: 18208801 (Publication Type: Journal Article)

Topics

• Biopsy, Fine-Needle (methods)
• Endosonography
• Gastrointestinal Neoplasms (diagnosis)
• Gastrointestinal Stromal Tumors (diagnosis)
• Humans
• Immunohistochemistry
• Leiomyoma (diagnosis)
• Neurilemmoma (diagnosis)
• Predictive Value of Tests