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From the Archives of the AFIP

Gastrointestinal Stromal Tumors: Radiologic Features with Pathologic Correlation¹

¹ From the Departments of Radiologic Pathology (A.D.L., W.M.T.), Hepatic and Gastrointestinal Pathology (H.E.R., L.H.S.), and Soft Tissue Pathology (M.M.), Armed Forces Institute of Pathology, 6825 16th St NW, Washington, DC 20306-6000; Department of Radiology and Nuclear Medicine, Uniformed Services University of the Health Sciences, Bethesda, Md (A.D.L.); and Department of Radiology, Duke University, Durham, NC (W.M.T.). Received August 30, 2002; revision requested October 3 and received October 11; accepted October 16. Address correspondence to A.D.L. (levya@afip.osd.mil).

Gastrointestinal stromal tumors (GISTs) are unique neoplasms that occur throughout the gastrointestinal tract, mesentery, omentum, and retroperitoneum. They are the most common mesenchymal neoplasm of the gastrointestinal tract and are defined by their expression of KIT (CD117), a tyrosine kinase growth factor receptor. The expression of KIT is important to distinguish GISTs from other mesenchymal neoplasms such as leiomyomas, leiomyosarcomas, schwannomas, and neurofibromas and to determine the appropriateness of KIT-inhibitor therapy. The series described herein was accumulated over 2 years and includes 64 pathologically proved GISTs (28 gastric, 27 small intestinal, six anorectal, one colonic, one esophageal, and one from the small bowel mesentery). Radiologic features of GISTs vary depending on tumor size and organ of origin. Since most GISTs arise within the muscularis propria of the stomach or intestinal wall, they most commonly have an exophytic growth pattern and manifest as dominant masses outside the organ of origin. Dominant intramural and intraluminal masses are less common radiologic manifestations. GISTs occurring in the gastrointestinal tract and mesentery characteristically have hemorrhage, necrosis, or cyst formation that appears as focal areas of low attenuation on computed tomographic images. Although the radiologic features of GISTs are often distinct from those of epithelial tumors, criteria to separate GISTs radiologically from other nonepithelial tumors have not yet been fully developed.

© RSNA, 2003

Index Terms: Gastrointestinal stromal tumor (GIST), 70.30 • Gastrointestinal tract, neoplasms, 70.30 • Intestinal neoplasms, 74.30 • Stomach, neoplasms, 72.30

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