Zusammenfassung
Die gastrointestinalen Stromatumoren (GIST) sind die bei weitem häufigsten Weichteiltumoren
im Gastrointestinaltrakt. Sie leiten sich von den interstitiellen Cajal-Zellen ab,
die sowohl eine leiomyogene als auch eine neurogene Differenzierung aufweisen können.
GIST kommen vom distalen Ösophagus bis zum Rektum sowie gelegentlich primär im Mesenterium
vor. Sie sind zellreiche, weiche Tumoren, die intraoperativ auf mechanische Einwirkung
leicht rupturieren. GIST metastasieren wie alle anderen Weichteiltumoren des Gastrointestinaltraktes
bevorzugt hämatogen. Die prospektive Beurteilung der Dignität und des klinischen Verlaufes
bei GIST ist problematisch, da die Tumorzellen die klassischen zyto- und histomorphologischen
Merkmale der Malignität nicht zeigen. Die Expression von c-KIT zeichnet GIST gegenüber
allen anderen spindelzelligen Weichteiltumoren im Gastrointestinaltrakt aus. Diese
Eigenschaft von GIST spielt sowohl bei der histopathologischen Differenzialdiagnose
als auch therapeutisch eine entscheidende Rolle.
Abstract
Gastrointestinal stromal tumour (GIST) is the most frequent soft tissue tumour of
the gastrointestinal tract. The tumour cells are derived from the interstitial cells
of Cajal, which can display either smooth muscle or neural differentiation. GIST occur
from the distal part of esophagus down to the rectum and rarely in the mesentery.
They are cellular tumours of soft consistency and bear a high risk of rupture upon
mechanical manipulation. GIST predominantly metastasize hematogenously. As tumour
cells do not display the typical cytomorphological characteristics of malignancy,
the prospective evaluation of malignancy and clinical course is uncertain. The unique
expression of c-KIT differentiates GIST from other mesenchymal tumours. This feature
is of great significance in the differential diagnosis and the therapeutic management.
Schlüsselwörter
Gastrointestinaler Stromatumor - Pathologie - Immunhistochemie - Differenzialdiagnose
Key words
Gastrointestinal stromal tumour - pathology - immunohistochemistry - differential
diagnosis
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Prof. Dr. med. L. Füzesi
Zentrum Pathologie, Universitätsklinikum Göttingen
Robert-Koch-Straße 40
37075 Göttingen
Telefon: + 49/551-396858
Fax: + 49/551-398627
eMail: fuezesi@med.uni-goettingen.de
