Medical imaging and immunohistochemical diagnosis of gastrointestinal stromal tumor originated from colon in a dog

개의 결장 간질종양에 대한 영상의학 및 면역조직화학 진단 1예

  • Choi, Jihye (Haemaru Referral Animal Hospital) ;
  • Kim, Hyunwook (Haemaru Referral Animal Hospital) ;
  • Lee, Haekyung (Haemaru Referral Animal Hospital) ;
  • Kim, Junyoung (College of Veterinary Medicine and BK21 Program for Veterinary Science, Seoul National University) ;
  • Yoon, Junghee (College of Veterinary Medicine and BK21 Program for Veterinary Science, Seoul National University)
  • 최지혜 (해마루 이차진료동물병원) ;
  • 김현욱 (해마루 이차진료동물병원) ;
  • 이혜경 (해마루 이차진료동물병원) ;
  • 김준영 (서울대학교 수의과대학 BK21 수의과학연구인력양성사업단) ;
  • 윤정희 (서울대학교 수의과대학 BK21 수의과학연구인력양성사업단)
  • Accepted : 2008.01.17
  • Published : 2008.03.30

Abstract

Gastrointestinal stromal tumor (GIST) is one of the mesenchymal tumors originated from gastrointestinal submucosa. A 10 year-old, male, mixed breed dog with persistent diarrhea, anorexia and lethargy was referred to Haemaru Animal Referral Hospital. Large mass originated from the transverse colon was observed and large amount of ascites and free gas were found on abdominal radiography and ultrasonography. The ascites was septic exudate mixed with bacteria that consisted with intestinal perforation. There was no metastatic lesion. This mass was tentatively diagnosed as adenocarcinoma, leiomyosarcoma (LMS) and lymphosarcoma and surgical resection and histilogical examination were planned. However, according to owner's request, the patient was euthanized and then the necropsy was performed. About 10 cm sized mass originated from the cecum, ascending colon and transverse colon was adhered to surrounding mesentery and the perforation and large amount of ascites were observed. GIST was suspected on histopathologic examination and confirmed according to CD 117 expression in immunohistochemistry. GIST, derived from interstitial cells of Cajal, can be distinguished from LMS and leiomyoma (LM) on the basis of expression of CD117 (KIT) immunohistochemically. GIST has a different biological behavior and clinical course compared with LMS and LM, therefore definite diagnosis for GIST using immunohistochemistry is clinically important to predict the precise prognosis of the patient.

Keywords

References

  1. 강동욱, 김주헌, 김동훈, 김경희, 박미자, 강대영. 위장관 간질종양에서 c-kit 유전자 돌연변이 및 면역조직화학적 발현. 대한병리학회지 2003, 37, 246-254
  2. Bettini G, Morini M, Marcato PS. Gastrointestinal spindle cell tumours of the dog: histological and immunohistochemical study. J Comp Pathol 2003, 129, 283-293 https://doi.org/10.1016/S0021-9975(03)00046-X
  3. Cohen M, Post GS, Wright JC. Gastrointestinal Leiomyosarcoma in 14 Dogs. J Vet Intern Med 2003, 17, 107-110 https://doi.org/10.1111/j.1939-1676.2003.tb01331.x
  4. Fletcher CD, Berman JJ, Corless C, Gorstein F, Lasota J, Longley BJ, Miettinen M, O'Leary TJ, Remotti H, Rubin BP, Shmookler B, Sobin LH, Weiss SW. Diagnosis of gastrointestinal stromal tumors: a consensus approach. Hum Pathol 2002, 33, 459-465 https://doi.org/10.1053/hupa.2002.123545
  5. Frost D, Lasota J, Miettinen M. Gastrointestinal stromal tumors and leiomyomas in the dog: a histopathologic, immunohistochemical, and molecular genetic study of 50 cases. Vet Pathol 2003, 40, 42-54 https://doi.org/10.1354/vp.40-1-42
  6. Koh JS, Trent J, Chen L, El-Naggar A, Hunt K, Pollock R, Zhang W. Gastrointestinal stromal tumors: overview of pathologic features, molecular biology, and therapy with imatinib mesylate. Histol Histopathol 2004, 19, 565-574
  7. Kumagai K, Uchida K, Miyamoto T, Ushigusa T, Shinohara S, Yamaguchi R, Tateyama S. Three cases of canine gastrointestinal stromal tumors with multiple differentiations and c-kit-expression. J Vet Med Sci 2003, 65, 1119-1122 https://doi.org/10.1292/jvms.65.1119
  8. LaRock RG, Ginn PE. Immunohistochemical staining characteristics of canine gastrointestinal stromal tumors. Vet Pathol 1997, 34, 303-311 https://doi.org/10.1177/030098589703400406
  9. Lennartsson J, Ronnstrand L. The stem cell factor receptor/c-KIT as a drug target in cancer. Curr Cancer Drug Targets 2006, 6, 65-75 https://doi.org/10.2174/156800906775471725
  10. Maas CPHJ, Haar GT, van der Gaag I, Kirpensteijn J. Reclassification of small intestinal and cecal smooth muscle tumors in 72 dogs: clinical, histologic, and immunohistochemical evaluation. Vet Surg 2007, 36, 302-313 https://doi.org/10.1111/j.1532-950X.2007.00271.x
  11. Miettinen M, Lasota J. Gastrointestinal stromal tumors (GISTs): definition, occurrence, pathology, differential diagnosis and molecular genetics. Pol J Pathol 2003, 54, 3-24
  12. Miettinen M, Sarlomo-Rikala M, Lasota J. Gastrointestinal stromal tumors: recent advances in understanding of their biology. Hum Pathol 1999, 30, 1213-1220 https://doi.org/10.1016/S0046-8177(99)90040-0
  13. Russell KN, Mehler SJ, Skorupski KA, Baez JL, Shofer FS, Goldschmidt MH. Clinical and immunohistochemical differentiation of gastrointestinal stromal tumors from leiomyosarcomas in dogs: 42 cases (1990-2003). J Am Vet Med Assoc 2007, 230, 1329-1333 https://doi.org/10.2460/javma.230.9.1329
  14. Selting KA. Tumors of the intestinal tract. In: Withrow SJ, MacEwin EG (eds.). Withrow and MacEwen's Small Animal Clinical Oncology. 4th ed. pp. 491-501, Saunders, Philadelphia, 2007
  15. Withrow JS. Gastric cancer. In: Withrow JS, MacEwin EG (eds.). Withrow and MacEwen's Small Animal Clinical Oncology. 4th ed. pp. 480-491, Saunders, Philadelphia, 2007