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Published on: April 3, 2026
Revision of gastrointestinal mesenchymal tumours with CD117
J P de Schipper1, R S L Liem, H F G M van den Ingh
1Department of Surgery, Medisch Centrum Rijnmond-Zuid locatie Clara, Olympiaweg 350, 3078 HT Rotterdam, The Netherlands.
Background:
Tyrosinekinase inhibitors improve the treatment of gastrointestinal stromal tumours (GISTs) and their diagnosis has been facilitated by recently developed immunohistochemical markers. It is hypothesised that in the past, the true incidence of GISTs has been underestimated.
Aims:
To study the clinicopathological features of previously resected mesenchymal tumours of the gastrointestinal tract and determine the accuracy of previous diagnostic results.
Patients And Methods:
Patients with mesenchymal tumours of the gastrointestinal tract operated on between 1987 and 2002 were identified using medical and pathologic files. Immunohistochemical staining for CD117, CD34, desmin and S100 was performed, and diagnosis reviewed.
Results:
Thirty-six mesenchymal tumours were reanalysed. Before revision, diagnosis of GIST was correctly made in only six cases. Supportive use of immunohistochemical markers for accurate diagnosis of the remaining 30 previously undefined mesenchymal tumours yielded 17 additional GISTs. Therefore, 23 of 36 (63%) gastrointestinal mesenchymal tumours were shown to be GISTs.
Conclusions:
The true incidence of GISTs has been underestimated. There is merit in reviewing the clinical diagnoses of all mesenchymal tumours of the gastrointestinal tract with modern immunohistochemical markers. This may enhance clinical decision making.
Insights
The true incidence of gastrointestinal stromal tumors (GISTs) has been underestimated. Reviewing past diagnoses with modern immunohistochemical markers improves accuracy and clinical decision-making for these mesenchymal tumors.
Area of Science:
- Gastrointestinal Pathology
- Oncology
- Immunohistochemistry
Background:
- Gastrointestinal stromal tumors (GISTs) treatment has improved with tyrosine kinase inhibitors.
- Recent advances in immunohistochemical markers have aided GIST diagnosis.
- The historical incidence of GISTs may have been underestimated.
Purpose of the Study:
- To investigate the clinicopathological features of resected gastrointestinal mesenchymal tumors.
- To assess the accuracy of prior diagnostic classifications.
- To determine the actual incidence of GISTs in a historical cohort.
Main Methods:
- Retrospective review of 36 mesenchymal tumors operated on between 1987 and 2002.
- Immunohistochemical staining performed for CD117, CD34, desmin, and S100.
- Re-evaluation of all diagnoses using updated diagnostic criteria and markers.
Main Results:
- Only 6 out of 36 initial diagnoses of GIST were correct.
- Immunohistochemistry identified an additional 17 GISTs from previously undefined tumors.
- GISTs constituted 63% (23 of 36) of the re-evaluated mesenchymal tumors.
Conclusions:
- The actual incidence of GISTs is higher than previously reported.
- Revisiting mesenchymal tumor diagnoses with immunohistochemistry is valuable.
- Accurate diagnosis enhances clinical decision-making for GIST patients.
