RESUMO
PURPOSE: Paraffin-embedded tissue samples from the gastrointestinal tract, which had been diagnosed as tumors of a mesenchymal origin, were reviewed by an immunohistochemical staining method. The prognostic significances of the immunohistochemical subtypes and anatomical locations were also investigated. GIST, as a new grading system, was compared with the pre-existing system for its useful prognostic significance. METHODS: 122 cases were evaluated and classified by immunohistochemical staining for KIT, CD34, actin, desmin, vimentin, S-100 protein and NSE. RESULTS: Positivity for both KIT and CD34 of 92.6 and 73.8%, respectively, indicated that KIT was more effective for the diagnosis of GISTs. The stomach (62.3%) and small bowel (23.7%) were most common organs of GIST. There was no difference in the prognosis between these two organs. Immunophenotypically, the uncommitted, myoid, combined and neural types were 37.7, 23.7, 20.2 and 7%, respectively. There was no significant difference in the prognosis between these types. The old grading system showed no difference between the borderline and malignant groups (P=0.14), whereas, the new grading system showed a significant difference between the intermediate and high risk groups (P=0.01). CONCLUSION: KIT is more useful for the diagnosis of GOSTs. The immunophenotypical classification and anatomical location showed no prognostic significance in GISTs. Therefore, the new grading system might be more useful than older system.
Assuntos
Actinas , Classificação , Desmina , Diagnóstico , Tumores do Estroma Gastrointestinal , Trato Gastrointestinal , Imuno-Histoquímica , Prognóstico , Proteínas S100 , Estômago , VimentinaRESUMO
Left atrial myxoma is a common primary tumor which frequently presents systemic embolizations. Embolization in various systemic organs is often the first and sometimes the only symptom in patient with cardiac myxoma. However, coronary embolization from the left atrial myxoma is very rare clinical presentation. We experienced 57-year-old woman with a left atrial myxoma combined with inferior myocardial infarction who had no stenotic lesion in coronary angiography. The ergonovine spasm test was negative. In the interleukin-6 immunohistochemical staining, the extracellular matrix of myxoma stained abundantly with pink color. It can be considered as inferior myocardial infarction due to embolization from the myxoma, which is associated with interleukin-6. So, we report this case with review of literature for the first time in Korea.