Omer Waqas¹*, Muhammed Aasim Yusuf², Muhammad Asghar³, Asif Loya¹ and Noreen Akhter¹

¹Departments of Pathology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Pakistan

*Corresponding Author: Omer Waqas, Departments of Pathology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Pakistan.

Received: March 06, 2023; Published: April 17, 2023

Abstract

Introduction: GIST is the most common gastric mesenchymal tumour and is diagnosed on the basis of a combination of clinical and radiological features, with biopsy being considered the gold standard. EUS-guided FNA is a minimally invasive procedure which, in combination with rapid on site evaluation or ROSE, is increasingly being utilized to diagnose lesions within and around the gastro-intestinal tract, and of the pancreas. In this study we aim to evaluate our experience in patients who were diagnosed with GIST on EUS-FNA.

Material and Methods: Thirteen patients [7 males, mean age 52 years] diagnosed with primary or metastatic GIST were diagnosed on EUS-FNA from January 2005 to June 2017 at Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan were included in the study. Lesions were assessed using an Olympus linear array echo-endoscope. In each case part of the sampled material obtained using a 22-gauge EUS-FNA needle was smeared on glass slides, air-dried and then stained with Diff-Quik^® stain for ROSE. One glass slide with smear was immediately dropped in 95% alcohol for Papanicolaou stain and the rest of the specimen was submitted for cell block in CytoLyt^®. A trained cytopathologist was present in the procedure room for ROSE on Diff-Quik^® stained slides. All slides and cell blocks were thoroughly examined and immunohistochemical (IHC) stains (CD117, DOG1, S100, Desmin and CK) were performed on the cell block material.

Results: The average size of the primary tumor in this study was 66.4 mm (range 30-120 mm) while metastatic tumors measured 15 mm each. Twelve tumours showed spindle cell morphology with only one mixed type. Mitoses were less than 5/10 HPF and no necrosis was seen. CD117 and DOG 1 were expressed in all thirteen cases.

Conclusion: Combining ROSE and IHC on cell-block material plays a vital role in confirming the diagnosis in both primary and metastatic GIST. Radiological findings can aid in risk assessment by documenting size and site. The diagnosis of GIST can be made confidently using EUS-FNA, even in resource-constraint settings.

Keywords: GIST; EUS-FNA; ROSE

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Citation

Citation: Omer Waqas., et al. “Diagnostic Utility of Endoscopic Ultrasound-Guided Fine Needle Aspiration (EUS-FNA) Biopsy in Evaluating Primary and Metastatic Gastrointestinal Stromal Tumors (GIST)". Acta Scientific Gastrointestinal Disorders 6.5 (2023): 23-31.

Copyright

Copyright: © 2023 Omer Waqas., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.