Bladder - Gastrointestinal stromal tumor (GIST)

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Gastrointestinal stromal tumor (GIST)

Reviewers: Turki Al-Hussain, M.D., Johns Hopkins Medical Centers (see Reviewers page)
Revised: 24 March 2011, last major update March 2011
Copyright: (c) 2003-2011, PathologyOutlines.com, Inc.

See also Stomach-GIST

Definition
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● Very rare mesenchymal tumor of CD117+ spindled or epithelioid cells, similar to counterpart in GI tract
● Reported cases are typically attached to external wall of bladder

Etiology
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● Arises from interstitial cells of Cajal

Case reports
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● 34 year old man with tumor attached to external bladder (Pathologica 2008;100:173)
● 52 year old woman with tumor attached to external bladder (Arch Pathol Lab Med 2000;124:894)

Treatment
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● Surgery, possibly kinase inhibitors such as imatinib mesylate (Gleevec)

Micro description
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● Sheets of spindled or epithelioid cells with dense collagenous background; mitoses are usually rare

Micro images
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Various images

Positive stains
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● CD117 (c-kit), CD34
● Dog-1 (Discovered on GIST-1)

Negative stains
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● S100, desmin

Molecular
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● c-kit mutations in exons 9 and 11
● PDGFRA mutation

Differential Diagnosis
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● Leiomyoma: smooth muscle phenotype with slender spindle cells containing eosinophilic cytoplasm and cigar shaped nuclei; desmin+, alpha smooth muscle actin+, CD117-, CD34-, no c-kit mutation
● Schwannoma: biphasic spindled tumor; nuclei have tapering ends; S100+, CD117-, CD34-, no c-kit mutation
● Inflammatory myofibroblast tumor: tissue culture growth pattern, ALK+, CD117-

End of Bladder > Other tumors > Gastrointestinal stromal tumor (GIST)

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