Gastrointestinaler Stromatumor: Pathologie

Zusammenfassung

Die gastrointestinalen Stromatumoren (GIST) sind die bei weitem häufigsten Weichteiltumoren im Gastrointestinaltrakt. Sie leiten sich von den interstitiellen Cajal-Zellen ab, die sowohl eine leiomyogene als auch eine neurogene Differenzierung aufweisen können. GIST kommen vom distalen Ösophagus bis zum Rektum sowie gelegentlich primär im Mesenterium vor. Sie sind zellreiche, weiche Tumoren, die intraoperativ auf mechanische Einwirkung leicht rupturieren. GIST metastasieren wie alle anderen Weichteiltumoren des Gastrointestinaltraktes bevorzugt hämatogen. Die prospektive Beurteilung der Dignität und des klinischen Verlaufes bei GIST ist problematisch, da die Tumorzellen die klassischen zyto- und histomorphologischen Merkmale der Malignität nicht zeigen. Die Expression von c-KIT zeichnet GIST gegenüber allen anderen spindelzelligen Weichteiltumoren im Gastrointestinaltrakt aus. Diese Eigenschaft von GIST spielt sowohl bei der histopathologischen Differenzialdiagnose als auch therapeutisch eine entscheidende Rolle.

Abstract

Gastrointestinal stromal tumour (GIST) is the most frequent soft tissue tumour of the gastrointestinal tract. The tumour cells are derived from the interstitial cells of Cajal, which can display either smooth muscle or neural differentiation. GIST occur from the distal part of esophagus down to the rectum and rarely in the mesentery. They are cellular tumours of soft consistency and bear a high risk of rupture upon mechanical manipulation. GIST predominantly metastasize hematogenously. As tumour cells do not display the typical cytomorphological characteristics of malignancy, the prospective evaluation of malignancy and clinical course is uncertain. The unique expression of c-KIT differentiates GIST from other mesenchymal tumours. This feature is of great significance in the differential diagnosis and the therapeutic management.

Schlüsselwörter

Gastrointestinaler Stromatumor - Pathologie - Immunhistochemie - Differenzialdiagnose

Key words

Gastrointestinal stromal tumour - pathology - immunohistochemistry - differential diagnosis

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