Stromal tumor of the pancreas with expression of c‐kit protein: Report of a case

Yamaura, Kazuo; Kato, Kunitaka; Miyazawa, Mitsuhiro; Haba, Yoshiaki; Muramatsu, Akira; Miyata, Kazuyuki; Koide, Naoki

doi:10.1111/j.1440-1746.2003.02891.x

Cited by 57 publications

(37 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In the differential diagnosis, a recurrent/metastatic GIST, which can also form a mass in the vicinity of the pancreas, was mentioned. However, there was no history of GIST in the two cases and in contrast to the reported stromal tumor of the pancreas, 24 the disorderly endocrine and exocrine pancreatic tissue embedded in the stroma in our cases does not readily fit the diagnosis of GIST. The expression of c-kit is required for the diagnosis GIST, but c-kit expression is not specific to this tumor entity.…”

Section: Resultscontrasting

confidence: 99%

See 1 more Smart Citation

Cellular hamartoma resembling gastrointestinal stromal tumor: a solid tumor of the pancreas expressing c-kit (CD117)

et al. 2005

View full text Add to dashboard Cite

Solid tumors of the pancreas are usually neoplastic. We report on two adult patients, each with a solid tumor of the pancreas that presented with an unusual histology and seemed to follow a benign course. The tumors, one located in the body and one in the tail, were well demarcated and composed of irregularly arranged but welldifferentiated acini and small intralobular and interlobular ducts embedded in predominantly hypocellular fibrotic tissue that contained fascicles of cytologically bland spindle cells. Islets were lacking, but immunohistochemical staining for chromogranin A and insulin revealed individual scattered insulin-producing cells distributed between acinar and ductal cells. The spindle cell component tissue showed coexpression of CD34, c-kit (CD117) and bcl-2. The follow-up (2 and 4 years) of the patients was uneventful. We propose to designate the tumors as 'cellular hamartoma resembling gastrointestinal stromal tumor.' Modern Pathology ( Keywords: pancreatic tumor; hamartoma; c-kit; CD34; bcl-2; differential diagnosis Well-demarcated tumor-like lesions in the pancreas are uncommon. They have been described under the term pseudotumor 1 or inflammatory pseudotumor. 2 Recently, we described a tumorous lesion that we termed pancreatic solid and cystic hamartoma. 3 Here we report on two further solid pancreatic tumors that have features in common with both hamartomas and gastrointestinal stromal tumors. Patients, materials and methodsThe cases were collected from the consultation files of the Department of Pathology of the University of Kiel, to which they had been submitted by the Department of Pathology in Dinslaken, Germany (case 1), and the Department of Pathology of the University of Coimbra, Portugal (case 2).In the first case, a 51-year-old man without clinical symptoms had a routine check-up, during which a mass, 3 cm in diameter, was detected by ultrasonography in the tail of the pancreas next to the splenic artery. This finding was confirmed by endosonography and CT. Laboratory tests were normal. As a result of the unclear nature of the tumor, abdominal surgery was performed with resection of the tumor.In the second case, a 54-year-old woman with slight abdominal discomfort was examined by ultrasonography, which revealed a well-demarcated tumor, 2 cm in diameter, in the body of the pancreas. A left-sided pancreatic resection was performed to remove the tumor. Both patients had an uncomplicated postoperative course and so far (2 and 4 years, respectively) have relapse-free follow-up.Representative 4 mm sections of formalin-fixed, paraffin-embedded tissue from both specimens were stained with hematoxylin and eosin (H&E) and periodic acid-Schiff. Immunohistochemical staining was performed using the standard avidinbiotin method against following antibodies: cytokeratin 8 (CAM 5

show abstract

Section: Resultscontrasting

confidence: 99%

“…The spectrum of pancreatic mesenchymal neoplasms was recently expanded by the description of an extragastrointestinal stromal tumor in the pancreas. 24 The tumor consisted of spindle-shaped cells that were immunoreactive for vimentin, CD34 and c-kit. In contrast to our cases it lacked any pancreatic exocrine or endocrine component.…”

Section: Resultsmentioning

confidence: 99%

Cellular hamartoma resembling gastrointestinal stromal tumor: a solid tumor of the pancreas expressing c-kit (CD117)

et al. 2005

View full text Add to dashboard Cite

show abstract

“…Last year, Yamaura et al [61] reported a case of a pancreatic stromal tumor, similar to GIST, since the spindle-shaped tumoral cells were immunoreactive for c-kit, CD34 and vimentin. Beyond the origin from primitive mesenchymal cells suggested by the authors, we consider that such tumor may originate from a subset of pICC that we described here.…”

Section: Discussionmentioning

confidence: 99%

Interstitial cells of Cajal in pancreas

et al. 2005

View full text Add to dashboard Cite

We show here (presumably for the first time) a special type of cell in the human and rat exocrine pancreas. These cells have phenotypic characteristics of the enteric interstitial cells of Cajal (ICC). To identify pancreatic interstitial cells of Cajal (pICC) we used routine light microscopy, non‐conventional light microscopy (less than 1 μm semi‐thin sections of Epon‐embedded specimens cut by ultramicrotomy and stained with Toluidine blue), transmission electron microscopy (TEM), and immunocytochemistry. The results showed that pICC can be recognized easily by light microscopy, particularly on semi‐thin sections, as well as by TEM. Two‐dimensional reconstructions from serial photos suggest a network‐like spatial distribution of pICC. pICC represent 3.3±0.5% of all pancreatic cells, and seem to establish close spatial relationships with: capillaries (43%), acini (40%), stellate cells (14%), nerve fibres (3%). Most of pICC (88%) have 2 or 3 long processes (tens of μm) emerging from the cell body. TEM data show that pICC meet the criteria for positive diagnosis as ICC (e.g. numerous mitochondria, 8.7±0.8% of cytoplasm). Immunocytochemistry revealed that pICC are CD117/c‐kit and CD34 positive. We found pICC positive (40–50%) for smooth muscle α‐actin or S‐100, and, occasionally, for CD68, NK1 neurokinin receptor and vimentin. The reactions for desmin and chromogranin A were negative in pICC. At present, only hypotheses and speculations can be formulated on the possible role of the pICC (e.g., juxtacrine and/or paracrine roles). In conclusion, the quite‐established dogma: “ICC only in cavitary organs” is overpassed.

show abstract

“…Spindle cell tumors similar to GIST have been reported in the extra-gastrointestinal sites such as omentum, mesentery, urinary bladder, gallbladder, retroperitoneum, and pancreas [103][104][105][106][107][108][109][110] and their incidence is frequent enough to be separately categorized as extra-gastrointestinal stromal tumors (eGIST). They seem to be indistinguishable from GIST in their cytomorphology, c-Kit expression and genetic changes.…”

Section: Extra-gastrointestinal Stromal Tumors (Egist)mentioning

confidence: 99%

Interstitial Cells of Cajal (ICC) and Gastrointestinal Stromal Tumor (GIST): facts, speculations, and myths

Min

Leabu

2006

Journal of Cellular and Molecular Medicine

View full text Add to dashboard Cite

Interstitial cells of Cajal (ICC) is a peculiar cell network composed of cells having processes described by the eminent Spanish neuroanatomist of the 19 th century, S. Ramon y Cajal. ICC became a fascinating subject to many investigators and it is estimated that there are over 100 publications yearly on the subject related to ICC, in the last three years. Now it is widely accepted that ICC are pace maker cells of the gut and probable progenitor cells of gastrointestinal stromal tumors (GIST). Lately, interstitial Cajal-like cells (ICLC) are being found in various organs and their physiological role is still to be defined. We have reviewed the literature trying to evaluate the validity of the current concept and found that there are a few salient points to be considered. 1) There has been some important departure in defining the identity of ICC from the original criteria of Cajal. In particular, ICC with myoid feafures in intestinal smooth muscle layers (ICC-DPM) do not seem to fit to the original description of interstitial cell network by Cajal. We have also pointed out that the current reports assigning a pace maker role to ICC vastly depend on the scientific data on "ICC with myoid features", not on "fibroblast-like ICC", which are more abundant and easier to identify. 2) There seem to be an overwhelming amount of data proving the relationship between ICC and GIST. Both are known to express c-Kit and the ultrastructural characteristics seen in GIST roughly parallel those of ICC including minimal myoid differentiation seen in the majority of GIST, supporting the current concept that GIST are ICC tumors. 3) According to the original description of Cajal, ICC was not limited to the gut, suggesting an existence of ICC in other organs. The list of organs reported to contain ICC (currently identified by immunohistochemistry and electron microscopy) is ever growing and further studies are needed to define their identity and pathophysiologic role. 4). Recent data concerning gut development suggest that both c-Kit expressing ICC (fibroblasts-like as well as muscle-like) and gut muscle cells Their physiologic role was not clear at that time and even today, but Cajal speculated on a possible ancillary neural function, because of their anatomic proximity and morphologic similarity to nerves. In fact, interstitial cells of the gut are neither neural nor muscular, but are interposed between nerve and muscle cells. He considered that they might play a controlling function of the gut motility, and he thereby stimulated many investigators to study his concept. Consequently, a vast amount of data has been accumulated on 1) their existence, 2) the ultrastructural characterization of a possible pacemaker role in the gut, 3) electrophysiologic studies of peristalsis, 4) c-Kit as a molecular marker of ICC, and 5) as progenitor cells of gastrointestinal stromal tumors (GIST). The data thus far accumulated is vast and complex, but has promulgated the definition and identification of ICC [19].In recent years, much interesti...

show abstract

Stromal tumor of the pancreas with expression of c‐kit protein: Report of a case

Cited by 57 publications

References 7 publications

Cellular hamartoma resembling gastrointestinal stromal tumor: a solid tumor of the pancreas expressing c-kit (CD117)

Cellular hamartoma resembling gastrointestinal stromal tumor: a solid tumor of the pancreas expressing c-kit (CD117)

Interstitial cells of Cajal in pancreas

Interstitial Cells of Cajal (ICC) and Gastrointestinal Stromal Tumor (GIST): facts, speculations, and myths

Contact Info

Product

Resources

About