Clinical Gastroenterology Vol.20 No.9(5-1)

Theme GIST (gastrointestinal stromal tumor)
Title Endoscopic Diagnosis of GIST Stomach and Esophagus
Publish Date 2005/08
Author Mitsuhiro Kida Department of Gastroenterology, Kitasato University East Hospital
Author Hidehiko Kikuchi Department of Gastroenterology, Kitasato University East Hospital
Author Kazuhide Kondo Department of Gastroenterology, Kitasato University East Hospital
Author Hiroshi Imaizumi Department of Gastroenterology, Kitasato University East Hospital
Author Yukihito Yamada Department of Gastroenterology, Kitasato University East Hospital
Author Tetsuaki Sakaguchi Department of Gastroenterology, Kitasato University East Hospital
Author Katsunori Saigenji Department of Gastroenterology, Kitasato University East Hospital
[ Summary ] GIMT (gastrointestinal mesenchymal tumor) is the term for mesenchymal tumors of the gastrointestinal tract, including submucosal tumors (SMT) which are c-kit and CD 34 positive. These are termed GIST, SMT with desmin and α-SMA, which is termed as a myogenic tumor, and SMT with s-100 which is termed a neurogenic tumor. GIST is rare in the esophagus and about half of the cases are stomach SMTs. GIMTs are detected as hypoechoic tumors originating from the fourth layer, however it is impossible to differentiate GISTs from myogenic or neurogenic tumors. Nevertheless, SMTs with three or more malignant indications, in which includes the following are : (1) larger than 3 cm, (2) nodular, (3) heterogeneous, (4) in the anechoic area or, (5) displaying ulceration, are suspected to be malignt and recommended to be operated on. In general, the sampling rate and diagnostic rate of EUS-FNA is around 80 - 90 %. It is also practical to diagnose the degree of GIST malignancy preoperatively with this method.
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