ZOIA STOICA(1), IOANA ANDREEA GHEONEA(1), ADRIANA BĂDULESCU(2)
(1)Radiology and Imaging Department,University of Medicine and Pharmacy Craiova,(2)Surgery Department,University of Medicine “Titu Maiorescu” Bucharest
REZUMAT
Tumorile stromale gastrointestinale (GIST) sunt rare, reprezentând mai puţin de 3% din totalitatea neoplaziilor gastrointestinale şi aproximativ 6% din totalitatea sarcoamelor. Scopul acestui studiului a fost analiza experienţei Departamentului de Imagistică Medicală - UMF Craiova în ceea ce priveşte pacienţii diagnosticaţi GIST.
Am realizat o retrospectivă a tuturor cazurilor înregistrate în departamentul nostru care au fost confirmate histologic. Am analizat caracteristicile imagistice ale GIST cu sublinierea aspectelor computer tomografice şi am evaluat extinderea metastazelor. Variabilele înregistrate au fost reprezentate de localizare, diametrul maxim al tumorii la prezentare, omogenitatea tumorii, conturul, şi aspectul după injectare de substanţă de contrast. Toate cazurile confirmate histologic au fost KIT pozitive iar activitatea mitotică a fost înaltă (>5 mitoze pe 50 HPF).
Din punct de vederea al localizării primare stomacul a fost sediul în peste 80% din cazuri. Cele mai multe dintre tumori au avut peste 5 cm, într-un caz nu s-a putut stabili dimensiunea exactă datorită diseminării extensive a bolii, heterogene, cu contur regulat şi încărcare periferică după administrarea substanţei de contrast. Metastaze la distanţă au fost evidenţiate la toţi pacienţii.
CUVINTE CHEIE GIST, tomografie computerizata, activitate mitotică
Experience of Imaging Department of University of Medicine and Pharmacy Craiova in Gastrointestinal Stromal Tumors (GIST)
ABSTRACT Gastrointestinal stromal tumors (GISTs) are rare, accounting for less than 3% of all gastrointestinal neoplasms and less than 6% of all sarcomas. The purpose of our study was to evaluate our experience involving patients with GISTs. We described the imaging features of GISTs with emphasis on CT, and we evaluated the patterns of metastatic spread.
We performed a retrospective review of medical records of all cases at our department with a histologic diagnosis of GIST. We recorded maximum tumor diameter at presentation (measured by CT), the mitotic activity and we visually assessed the homogeneity of the tumor and contrast enhancement. All cases had a histologically confirmed diagnosis of GIST and were KIT-positive. Analysis of metastatic patterns included review of all imaging available prior to treatment.
Stomach accounted for more than 80% of the primary sites. The sizes of most tumors were over 5 cm, in one case it was unknown because of the extensive dissemination of the disease, and the mitotic activity was high (>5 mitoses per 50 HPF). Distant metastases occurred in all patients. CT scans prior to therapy were available for review in all ten cases.
(1)Radiology and Imaging Department,University of Medicine and Pharmacy Craiova,(2)Surgery Department,University of Medicine “Titu Maiorescu” Bucharest
REZUMAT
Tumorile stromale gastrointestinale (GIST) sunt rare, reprezentând mai puţin de 3% din totalitatea neoplaziilor gastrointestinale şi aproximativ 6% din totalitatea sarcoamelor. Scopul acestui studiului a fost analiza experienţei Departamentului de Imagistică Medicală - UMF Craiova în ceea ce priveşte pacienţii diagnosticaţi GIST.
Am realizat o retrospectivă a tuturor cazurilor înregistrate în departamentul nostru care au fost confirmate histologic. Am analizat caracteristicile imagistice ale GIST cu sublinierea aspectelor computer tomografice şi am evaluat extinderea metastazelor. Variabilele înregistrate au fost reprezentate de localizare, diametrul maxim al tumorii la prezentare, omogenitatea tumorii, conturul, şi aspectul după injectare de substanţă de contrast. Toate cazurile confirmate histologic au fost KIT pozitive iar activitatea mitotică a fost înaltă (>5 mitoze pe 50 HPF).
Din punct de vederea al localizării primare stomacul a fost sediul în peste 80% din cazuri. Cele mai multe dintre tumori au avut peste 5 cm, într-un caz nu s-a putut stabili dimensiunea exactă datorită diseminării extensive a bolii, heterogene, cu contur regulat şi încărcare periferică după administrarea substanţei de contrast. Metastaze la distanţă au fost evidenţiate la toţi pacienţii.
CUVINTE CHEIE GIST, tomografie computerizata, activitate mitotică
Experience of Imaging Department of University of Medicine and Pharmacy Craiova in Gastrointestinal Stromal Tumors (GIST)
ABSTRACT Gastrointestinal stromal tumors (GISTs) are rare, accounting for less than 3% of all gastrointestinal neoplasms and less than 6% of all sarcomas. The purpose of our study was to evaluate our experience involving patients with GISTs. We described the imaging features of GISTs with emphasis on CT, and we evaluated the patterns of metastatic spread.
We performed a retrospective review of medical records of all cases at our department with a histologic diagnosis of GIST. We recorded maximum tumor diameter at presentation (measured by CT), the mitotic activity and we visually assessed the homogeneity of the tumor and contrast enhancement. All cases had a histologically confirmed diagnosis of GIST and were KIT-positive. Analysis of metastatic patterns included review of all imaging available prior to treatment.
Stomach accounted for more than 80% of the primary sites. The sizes of most tumors were over 5 cm, in one case it was unknown because of the extensive dissemination of the disease, and the mitotic activity was high (>5 mitoses per 50 HPF). Distant metastases occurred in all patients. CT scans prior to therapy were available for review in all ten cases.
KEY WORDS GIST, computed tomography, mitotic activity