Description

Pauwels et al described a number of phenotypic changes that occur in a gastrointestinal stromal tumor (GIST) following prolonged therapy with imatinib mesylate. Recognition of these changes can prevent misdiagnosis. The authors are from Maastricht Academic Medical Center, University of Leuven, University Hospital in Gasthuisberg and Catholic Hospital of Leuven in the Netherlands and Belgium.


Phenotypic Feature

Before Imatinib

After Imatinib

histologic appearance

spindle cells

epithelioid, diffuse or pseudopapillary

CD117

positive

negative

CD34

positive

positive or negative

desmin

negative

positive or negative

 

Mutational analysis of KIT of the post-treatment tumors will show distinct exon 11 mutant isoforms, confirming the diagnosis of GIST.

 


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