Levy Angela D, Remotti Helen E, Thompson William M, Sobin Leslie H, Miettinen Markku
Department of Radiologic Pathology, Armed Forces Institute of Pathology, 6825 16th St NW, Washington, DC 20306-6000, USA.
Radiographics. 2003 Mar-Apr;23(2):283-304, 456; quiz 532. doi: 10.1148/rg.232025146.
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.
胃肠道间质瘤（GISTs）是一种独特的肿瘤，可发生于整个胃肠道、肠系膜、网膜和腹膜后。它们是胃肠道最常见的间叶性肿瘤，其定义为表达KIT（CD117），一种酪氨酸激酶生长因子受体。KIT的表达对于将GISTs与其他间叶性肿瘤如平滑肌瘤、平滑肌肉瘤、神经鞘瘤和神经纤维瘤相区分以及确定KIT抑制剂治疗的适用性很重要。本文所述系列病例积累超过2年，包括64例经病理证实的GISTs（28例胃，27例小肠，6例肛管直肠，1例结肠，1例食管，1例来自小肠系膜）。GISTs的放射学特征因肿瘤大小和起源器官而异。由于大多数GISTs起源于胃或肠壁的固有肌层，它们最常见的生长方式为外生性生长，表现为起源器官外的主要肿块。主要的壁内和腔内肿块是较少见的放射学表现。发生于胃肠道和肠系膜中的GISTs特征性地有出血、坏死或囊肿形成，在计算机断层扫描图像上表现为低密度灶。尽管GISTs的放射学特征通常与上皮性肿瘤不同，但从放射学上区分GISTs与其他非上皮性肿瘤的标准尚未完全确立。
