A 43 year old man with GI symptoms was found to have a mass of approximately 4 cm in the stomach.. Specimen sent for biopsy.. Histopathology images attached .. Diagnosis ??



Differential Diagnosis - Leiomyoma -GIST - Inflammatory Fibroid Polyp


GIST. Advice IHC with c kit, CD 34.

GIST 1st slide appears to be CD 117+

Hello all , it is a case of GIST ( stomach) Two thirds of all GIST tumors arise in the stomach, where their behavior is usually benign.  In the stomach, poor prognostic factors are location in the fundus or GE junction, coagulative necrosis, ulceration and mucosal invasion. Morphology for tumors from various sites has also been used to predict behavior, with pure or mixed cellular spindle cell or epithelioid cell patterns associated with benign behavior and other patterns considered not to be benign.   These tumors are immunoreactive for CD117 / KIT, as well as CD34.  Of note, the interstitial cell of Cajal is also CD117+ and CD34+.   A novel therapy for metastatic or unresectable CD117+ GIST tumors, as well as CML and other CD117+ tumors, is STI-571 , an inhibitor of receptor tyrosine kinase.  It inhibits constitutive activation of mutated KIT, and confirmation of KIT immunoexpression is required for its use  In the present case, with no evidence of metastatic tumor, treatment consisted only of tumor excision.

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