Histopathological spectrum of spindle cell tumours of gastro-intestinal tract
Keywords:Fibromatosis, Gastrointestinal stromal tumour, Gastrointestinal tract, Inflammatory fibroid polyp, Inflammatory myofibroblast, Schwannoma, Tumour Spindle cell lesions
Background: Spindle cell lesions of gastro-intestinal tract (GIT) are relatively uncommon tumours compared to epithelial tumours. The anatomic location of spindle cell tumour is important, whether the tumour is located in mucosa, submucosa or muscularis propria.
Methods: Authors endeavoured to study the histopathological spectrum of spindle cell lesions for a period of one year from January 2018 to December 2018 in our hospital.
Results: This was a prospective study of 1 year starting from January 2018 to December 2018. A total of 30 cases of spindle cell lesions of gastrointestinal tract were seen. Out of 30 cases 23 were gastrointestinal stromal tumours (GIST), 2 cases were schwannomas, 2 cases were of leiomyomas, 1 case was fibromatosis, 1 case was inflammatory fibroid polyp, and one case was inflammatory myofibroblast tumour.
Conclusion: GISTs are the commonest spindle cell tumours of GIT. Besides GIST, there are other spindle cell tumours which range from benign to malignant, and need to be differentiated from GIST for proper management.
Virani N, Pang J, Lew M. Cytologic and immunohistochemical evaluation of low-grade spindle cell lesions of the gastrointestinal tract. Arch Pathol Lab Med.. 2016 Oct;140(10):1038-44.
Voltaggio L, Montgomery EA. Gastrointestinal tract spindle cell lesions- just like real estate, it is all about location. Modern Pathol. 2015;28(S1):47-66.
Miettinen M, Sarlomo-Rikala M, Sobin LH. Mesenchymal tumours of muscularis mucosae of colon and rectum are benign leiomyomas that should be separated from gastrointestinal stromal tumours - A clinicopathologic and immunohistochemical study of eighty-eight cases. Mod Pathol. 2001;14(10):950-6.
Rosai J. Gastrointestinal stromal tumour and its mimics. Int J Surg Pathol. 2010;18: S79-87.
Sahid J, Nadira M, Mushtaq S, Luqman M. Analysis of gastrointestinal malignancies at the armed forces institute of pathology, Rawalpindi, Pakistan. Asian Pac J of cancer prev. 2005;6(4):497-500.
Pandith A, Siddiqi M. Burden of cancers in the valley of Kashmir.5-year epidemiological study reveals a different scenario. Tumour Biol. 2012 Oct; 33(5):1629-37.
Emory TS, Sobin LH, Lukes L, Lee DH, O'Leary TJ. Prognosis of gastrointestinal smooth-muscle (stromal) tumors: dependence on anatomic site. The Am J surgical pathol. 1999 Jan 1;23(1):82-7.
Miettinen M, Wang ZF, Lasota J. DOG1 antibody in the differential diagnosis of gastrointestinal stromal tumours: a study of 1840 cases. Am J SurgPathol. 2009;33(9):1401-8.
Guler ML, Daniels JA, Abraham SC, Montgomery EA. Expression of melanoma antigens in epithelioid gastrointestinal stromal tumours: a potential diagnostic pitfall. Arch Pathol Lab Med.2008;132(8):1302-6.
Vanek J. Gastric submucosal granuloma with eosinophilic infiltration. Am J Pathol.1949;25:397-411.
Liu TC, Lin MT, Montgomery EA, Singhi AD. Inflammatory fibroid polyps of the gastrointestinal tract: spectrum of clinical, morphologic, and immunohistochemistry features. Am J SurgPathol. 2013;37(4):586-92.
Allibone RO, Nanson JK, Anthony PP. Multiple and recurrent inflammatory fibroid polyps in a Devon family ('Devon polyposis syndrome'): an update. Gut.1992;33(7):1004-5.
Anthony PP, Morris DS, Vowles KD. Multiple and recurrent inflammatory fibroid polyps in three generations of a Devon family: a new syndrome. Gut.1984;25(8):854-62.
Schildhaus HU, Cavlar T, Binot E, Büttner R, Wardelmann E, Merkelbach‐Bruse S. Inflammatory fibroid polyps harbour mutations in the platelet‐derived growth factor receptor alpha (PDGFRA) gene. J Pathol: A Journal of the Pathological Society of Great Britain and Ireland. 2008 Oct;216(2):176-82.
Voltaggio L, Murray R, Lasota J, Miettinen M. Gastric schwannoma: a clinicopathologic study of 51 cases and critical review of the literature. Human pathol. 2012 May 1;43(5):650-9.
Rodriguez E, Tellschow S, Steinberg DM, Montgomery E. Cytologic findings of gastric schwannoma: a case report. Diagn Cytopathol.2014;42(2):177-80.
Narla LD, Newman B, Spottswood SS, Narla S, Kolli R. Inflammatory pseudotumor. Radiographi. 2003 May;23(3):719-29.