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Gastrointestinal
Diagnosis
Stomach
Malignant Neoplasms
Gastric GIST
Gastric GIST
Michael P. Federle, MD, FACR; R. Brooke Jeffrey, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Abbreviations

                • Gastrointestinal stromal tumor (GIST)

              • Definitions

                • Submucosal tumor of gastrointestinal (GI) tract derived from interstitial cells of Cajal

              IMAGING

              • General Features

                • Fluoroscopic Findings

                  • CT Findings

                    • MR Findings

                      • Ultrasonographic Findings

                        • Nuclear Medicine Findings

                          • Imaging Recommendations

                            DIFFERENTIAL DIAGNOSIS

                              PATHOLOGY

                              • General Features

                                • Staging, Grading, & Classification

                                  • Gross Pathologic & Surgical Features

                                    • Microscopic Features

                                      CLINICAL ISSUES

                                      • Presentation

                                        • Demographics

                                          • Natural History & Prognosis

                                            • Treatment

                                              DIAGNOSTIC CHECKLIST

                                              • Consider

                                                • Image Interpretation Pearls

                                                  Selected References

                                                  1. Corless CL et al: Pathologic and molecular features correlate with long-term outcome after adjuvant therapy of resected primary GI stromal tumor: the ACOSOG Z9001 trial. J Clin Oncol. 32(15):1563-70, 2014
                                                  2. Tap WD et al: That's the "GIST" of it: use of adjuvant imatinib after resection of a primary GI stromal tumor. J Clin Oncol. 32(15):1543-6, 2014
                                                  3. De Vogelaere K et al: Gastrointestinal stromal tumor of the stomach: progresses in diagnosis and treatment. Acta Gastroenterol Belg. 76(4):403-6, 2013
                                                  4. Holdsworth CH et al: CT and PET: early prognostic indicators of response to imatinib mesylate in patients with gastrointestinal stromal tumor. AJR Am J Roentgenol. 189(6):W324-30, 2007
                                                  5. Lassau N et al: Gastrointestinal stromal tumors treated with imatinib: monitoring response with contrast-enhanced sonography. AJR Am J Roentgenol. 187(5):1267-73, 2006
                                                  6. Warakaulle DR et al: MDCT appearance of gastrointestinal stromal tumors after therapy with imatinib mesylate. AJR Am J Roentgenol. 186(2):510-5, 2006
                                                  7. Antoch G et al: Comparison of PET, CT, and dual-modality PET/CT imaging for monitoring of imatinib (STI571) therapy in patients with gastrointestinal stromal tumors. J Nucl Med. 45(3):357-65, 2004
                                                  8. Gayed I et al: The role of 18F-FDG PET in staging and early prediction of response to therapy of recurrent gastrointestinal stromal tumors. J Nucl Med. 45(1):17-21, 2004
                                                  9. Haider N et al: Gastric stromal tumors in children. Pediatr Blood Cancer. 42(2):186-9, 2004
                                                  10. Logrono R et al: Recent advances in cell biology, diagnosis, and therapy of gastrointestinal stromal tumor (GIST). Cancer Biol Ther. 3(3)251-8, 2004
                                                  11. Bechtold RE et al: Cystic changes in hepatic and peritoneal metastases from gastrointestinal stromal tumors treated with Gleevec. Abdom Imaging. 28(6):808-14, 2003
                                                  12. Besana-Ciani I et al: Outcome and long term results of surgical resection for gastrointestinal stromal tumors (GIST). Scand J Surg. 92(3):195-9, 2003
                                                  13. Burkill GJ et al: Malignant gastrointestinal stromal tumor: distribution, imaging features, and pattern of metastatic spread. Radiology. 226(2):527-32, 2003
                                                  14. Connolly EM et al: Gastrointestinal stromal tumours. Br J Surg. 90(10):1178-86, 2003
                                                  15. Dong Q et al: Epithelioid variant of gastrointestinal stromal tumor: Diagnosis by fine-needle aspiration. Diagn Cytopathol. 29(2):55-60, 2003
                                                  16. Duffaud F et al: Gastrointestinal stromal tumors: biology and treatment. Oncology. 65(3):187-97, 2003
                                                  17. Frolov A et al: Response markers and the molecular mechanisms of action of Gleevec in gastrointestinal stromal tumors. Mol Cancer Ther. 2(8):699-709, 2003
                                                  18. Ghanem N et al: Computed tomography in gastrointestinal stromal tumors. Eur Radiol. 13(7):1669-78, 2003
                                                  19. Kinoshita K et al: Endoscopic ultrasonography-guided fine needle aspiration biopsy in follow-up patients with gastrointestinal stromal tumours. Eur J Gastroenterol Hepatol. 15(11):1189-93, 2003
                                                  20. Lin SC et al: Clinical manifestations and prognostic factors in patients with gastrointestinal stromal tumors. World J Gastroenterol. 9(12):2809-12, 2003
                                                  21. Reddy MP et al: F-18 FDG PET imaging in gastrointestinal stromal tumor. Clin Nucl Med. 28(8):677-9, 2003
                                                  22. Rosai J: GIST: an update. Int J Surg Pathol. 11(3):177-86, 2003
                                                  23. Rossi CR et al: Gastrointestinal stromal tumors: from a surgical to a molecular approach. Int J Cancer. 107(2):171-6, 2003
                                                  24. Tateishi U et al: Gastrointestinal stromal tumor. Correlation of computed tomography findings with tumor grade and mortality. J Comput Assist Tomogr. 27(5):792-8, 2003
                                                  25. Wong NA et al: Prognostic indicators for gastrointestinal stromal tumours: a clinicopathological and immunohistochemical study of 108 resected cases of the stomach. Histopathology. 43(2):118-26, 2003
                                                  26. Wu PC et al: Surgical treatment of gastrointestinal stromal tumors in the imatinib (STI-571) era. Surgery. 134(4):656-65; discussion 665-6, 2003
                                                  27. Belloni M et al: Endoscopic ultrasound and Computed Tomography in gastric stromal tumours. Radiol Med (Torino). 103(1-2):65-73, 2002
                                                  28. Miettinen M et al: Evaluation of malignancy and prognosis of gastrointestinal stromal tumors: a review. Hum Pathol. 33(5):478-83, 2002
                                                  29. Kim CJ et al: Gastrointestinal stromal tumors: analysis of clinical and pathologic factors. Am Surg. 67(2):135-7, 2001
                                                  Related Anatomy
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                                                  Related Differential Diagnoses
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                                                  References
                                                  Tables

                                                  Tables

                                                  KEY FACTS

                                                  • Terminology

                                                    • Imaging

                                                      • Top Differential Diagnoses

                                                        • Pathology

                                                          • Clinical Issues

                                                            • Diagnostic Checklist

                                                              TERMINOLOGY

                                                              • Abbreviations

                                                                • Gastrointestinal stromal tumor (GIST)

                                                              • Definitions

                                                                • Submucosal tumor of gastrointestinal (GI) tract derived from interstitial cells of Cajal

                                                              IMAGING

                                                              • General Features

                                                                • Fluoroscopic Findings

                                                                  • CT Findings

                                                                    • MR Findings

                                                                      • Ultrasonographic Findings

                                                                        • Nuclear Medicine Findings

                                                                          • Imaging Recommendations

                                                                            DIFFERENTIAL DIAGNOSIS

                                                                              PATHOLOGY

                                                                              • General Features

                                                                                • Staging, Grading, & Classification

                                                                                  • Gross Pathologic & Surgical Features

                                                                                    • Microscopic Features

                                                                                      CLINICAL ISSUES

                                                                                      • Presentation

                                                                                        • Demographics

                                                                                          • Natural History & Prognosis

                                                                                            • Treatment

                                                                                              DIAGNOSTIC CHECKLIST

                                                                                              • Consider

                                                                                                • Image Interpretation Pearls

                                                                                                  Selected References

                                                                                                  1. Corless CL et al: Pathologic and molecular features correlate with long-term outcome after adjuvant therapy of resected primary GI stromal tumor: the ACOSOG Z9001 trial. J Clin Oncol. 32(15):1563-70, 2014
                                                                                                  2. Tap WD et al: That's the "GIST" of it: use of adjuvant imatinib after resection of a primary GI stromal tumor. J Clin Oncol. 32(15):1543-6, 2014
                                                                                                  3. De Vogelaere K et al: Gastrointestinal stromal tumor of the stomach: progresses in diagnosis and treatment. Acta Gastroenterol Belg. 76(4):403-6, 2013
                                                                                                  4. Holdsworth CH et al: CT and PET: early prognostic indicators of response to imatinib mesylate in patients with gastrointestinal stromal tumor. AJR Am J Roentgenol. 189(6):W324-30, 2007
                                                                                                  5. Lassau N et al: Gastrointestinal stromal tumors treated with imatinib: monitoring response with contrast-enhanced sonography. AJR Am J Roentgenol. 187(5):1267-73, 2006
                                                                                                  6. Warakaulle DR et al: MDCT appearance of gastrointestinal stromal tumors after therapy with imatinib mesylate. AJR Am J Roentgenol. 186(2):510-5, 2006
                                                                                                  7. Antoch G et al: Comparison of PET, CT, and dual-modality PET/CT imaging for monitoring of imatinib (STI571) therapy in patients with gastrointestinal stromal tumors. J Nucl Med. 45(3):357-65, 2004
                                                                                                  8. Gayed I et al: The role of 18F-FDG PET in staging and early prediction of response to therapy of recurrent gastrointestinal stromal tumors. J Nucl Med. 45(1):17-21, 2004
                                                                                                  9. Haider N et al: Gastric stromal tumors in children. Pediatr Blood Cancer. 42(2):186-9, 2004
                                                                                                  10. Logrono R et al: Recent advances in cell biology, diagnosis, and therapy of gastrointestinal stromal tumor (GIST). Cancer Biol Ther. 3(3)251-8, 2004
                                                                                                  11. Bechtold RE et al: Cystic changes in hepatic and peritoneal metastases from gastrointestinal stromal tumors treated with Gleevec. Abdom Imaging. 28(6):808-14, 2003
                                                                                                  12. Besana-Ciani I et al: Outcome and long term results of surgical resection for gastrointestinal stromal tumors (GIST). Scand J Surg. 92(3):195-9, 2003
                                                                                                  13. Burkill GJ et al: Malignant gastrointestinal stromal tumor: distribution, imaging features, and pattern of metastatic spread. Radiology. 226(2):527-32, 2003
                                                                                                  14. Connolly EM et al: Gastrointestinal stromal tumours. Br J Surg. 90(10):1178-86, 2003
                                                                                                  15. Dong Q et al: Epithelioid variant of gastrointestinal stromal tumor: Diagnosis by fine-needle aspiration. Diagn Cytopathol. 29(2):55-60, 2003
                                                                                                  16. Duffaud F et al: Gastrointestinal stromal tumors: biology and treatment. Oncology. 65(3):187-97, 2003
                                                                                                  17. Frolov A et al: Response markers and the molecular mechanisms of action of Gleevec in gastrointestinal stromal tumors. Mol Cancer Ther. 2(8):699-709, 2003
                                                                                                  18. Ghanem N et al: Computed tomography in gastrointestinal stromal tumors. Eur Radiol. 13(7):1669-78, 2003
                                                                                                  19. Kinoshita K et al: Endoscopic ultrasonography-guided fine needle aspiration biopsy in follow-up patients with gastrointestinal stromal tumours. Eur J Gastroenterol Hepatol. 15(11):1189-93, 2003
                                                                                                  20. Lin SC et al: Clinical manifestations and prognostic factors in patients with gastrointestinal stromal tumors. World J Gastroenterol. 9(12):2809-12, 2003
                                                                                                  21. Reddy MP et al: F-18 FDG PET imaging in gastrointestinal stromal tumor. Clin Nucl Med. 28(8):677-9, 2003
                                                                                                  22. Rosai J: GIST: an update. Int J Surg Pathol. 11(3):177-86, 2003
                                                                                                  23. Rossi CR et al: Gastrointestinal stromal tumors: from a surgical to a molecular approach. Int J Cancer. 107(2):171-6, 2003
                                                                                                  24. Tateishi U et al: Gastrointestinal stromal tumor. Correlation of computed tomography findings with tumor grade and mortality. J Comput Assist Tomogr. 27(5):792-8, 2003
                                                                                                  25. Wong NA et al: Prognostic indicators for gastrointestinal stromal tumours: a clinicopathological and immunohistochemical study of 108 resected cases of the stomach. Histopathology. 43(2):118-26, 2003
                                                                                                  26. Wu PC et al: Surgical treatment of gastrointestinal stromal tumors in the imatinib (STI-571) era. Surgery. 134(4):656-65; discussion 665-6, 2003
                                                                                                  27. Belloni M et al: Endoscopic ultrasound and Computed Tomography in gastric stromal tumours. Radiol Med (Torino). 103(1-2):65-73, 2002
                                                                                                  28. Miettinen M et al: Evaluation of malignancy and prognosis of gastrointestinal stromal tumors: a review. Hum Pathol. 33(5):478-83, 2002
                                                                                                  29. Kim CJ et al: Gastrointestinal stromal tumors: analysis of clinical and pathologic factors. Am Surg. 67(2):135-7, 2001