Type:
Educational Exhibit
Keywords:
Computer Applications-Detection, diagnosis, Computer Applications-3D, CT-High Resolution, CT-Angiography, CT, Oncology, Gastrointestinal tract, Abdomen, Cancer, Metastases
Authors:
D. L. Lauretti, B. Ginanni, A. Mantarro, P. Vagli, E. Neri, C. Bartolozzi, R. Scandiffio; Pisa/IT
DOI:
10.1594/ecr2013/C-2549
Conclusion
GISTs are the most common non-epithelial neoplasms of GI tract,
defined as KIT-positive mesenchymal spindle-or-epithelioid-cells neoplasm,
occurring primarily in the GI-tract,
omentum,
or mesentery.
GISTs arise from the muscularis propria of the bowel wall and,
when they reach a huge size,
the mass tend to extend towards the extramural and intraluminal layers.
Frequently,
benign GISTs (size 2 ≥ 5 cm and mitotic count ≤ 5/50 HPF) rarely give metastasis.
Indeed,
metastases represent a typical signs of malignancy,
including liver involvement and intra-abdominal dissemination.
Lymph node involvement and lung or bone metastases are uncommon.
(When metastasis are present they usually involve the liver or spread diffusely in the abdomen,
in a minority of cases to bone and lung.)
Thanks to high spatial and contrast resolution,
CT scan is the gold standard for GISTs diagnosis,
allowing to establish the organ of origin; to determine the lesion size,
shape,
and extent; to evaluate density and enhancing patterns; and to detect the presence of metastasis.
Furthermore,
CT provides information on morphological changes during follow-up after chemotherapy,
differentiating GISTs
from other stromal tumors,
that often are submucosal in origin.