Diagnostic considerations for gastrointestinal stromal tumors with altered immunophenotype following Imatinib treatment: A case report and literature review

Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors in the gastrointestinal tract and have a high rate of recurrence and metastasis. Using an immunohistochemical (IHC) panel including KIT/CD117 and DOG1 allows for accurate diagnosis in more than 98% of cases. However, afte...

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Main Authors: Jihuan Chen, Liz M. Yang, Jonathan Somma, Yujun Gan, Zengying Wu, Zhiyan Fu
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:Human Pathology Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S2772736X25000088
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author Jihuan Chen
Liz M. Yang
Jonathan Somma
Yujun Gan
Zengying Wu
Zhiyan Fu
author_facet Jihuan Chen
Liz M. Yang
Jonathan Somma
Yujun Gan
Zengying Wu
Zhiyan Fu
author_sort Jihuan Chen
collection DOAJ
description Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors in the gastrointestinal tract and have a high rate of recurrence and metastasis. Using an immunohistochemical (IHC) panel including KIT/CD117 and DOG1 allows for accurate diagnosis in more than 98% of cases. However, after tyrosine kinase inhibitor treatment, some cases can exhibit histologic dedifferentiation and loss of KIT/CD117 and DOG1 expression that may cause difficulty in confirming recurrent or persistent disease. We present such a case of an Imatinib treated, CD117 and DOG1 dual negative, metastatic GIST to the liver in a 55-year-old female which required molecular analysis to confirm the diagnosis. Awareness and recognition of this phenomenon is crucial for the accurate diagnosis and management of patients with GISTs.
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issn 2772-736X
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series Human Pathology Reports
spelling doaj-art-542f4a2ec32a4793aa67140e3adc49e42025-08-20T02:05:10ZengElsevierHuman Pathology Reports2772-736X2025-06-014030077610.1016/j.hpr.2025.300776Diagnostic considerations for gastrointestinal stromal tumors with altered immunophenotype following Imatinib treatment: A case report and literature reviewJihuan Chen0Liz M. Yang1Jonathan Somma2Yujun Gan3Zengying Wu4Zhiyan Fu5Department of Pathology, Louisiana State University Health Sciences Center, New Orleans, LA 70112, United StatesDepartment of Pathology, Louisiana State University Health Sciences Center, New Orleans, LA 70112, United StatesDepartment of Pathology, Louisiana State University Health Sciences Center, New Orleans, LA 70112, United StatesDepartment of Pathology and Laboratory Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH 03755, United StatesClinical Volunteer Service, University Medical Center, New Orleans, LA 70112, United StatesDepartment of Pathology, Louisiana State University Health Sciences Center, New Orleans, LA 70112, United States; Corresponding author at: Department of Pathology, LSUHSC School of Medicine, New Orleans, LA 70112, United States.Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors in the gastrointestinal tract and have a high rate of recurrence and metastasis. Using an immunohistochemical (IHC) panel including KIT/CD117 and DOG1 allows for accurate diagnosis in more than 98% of cases. However, after tyrosine kinase inhibitor treatment, some cases can exhibit histologic dedifferentiation and loss of KIT/CD117 and DOG1 expression that may cause difficulty in confirming recurrent or persistent disease. We present such a case of an Imatinib treated, CD117 and DOG1 dual negative, metastatic GIST to the liver in a 55-year-old female which required molecular analysis to confirm the diagnosis. Awareness and recognition of this phenomenon is crucial for the accurate diagnosis and management of patients with GISTs.http://www.sciencedirect.com/science/article/pii/S2772736X25000088Gastrointestinal stromal tumors (GISTs)CD117DOG1Imatinibc-KITImmunohistochemistry
spellingShingle Jihuan Chen
Liz M. Yang
Jonathan Somma
Yujun Gan
Zengying Wu
Zhiyan Fu
Diagnostic considerations for gastrointestinal stromal tumors with altered immunophenotype following Imatinib treatment: A case report and literature review
Human Pathology Reports
Gastrointestinal stromal tumors (GISTs)
CD117
DOG1
Imatinib
c-KIT
Immunohistochemistry
title Diagnostic considerations for gastrointestinal stromal tumors with altered immunophenotype following Imatinib treatment: A case report and literature review
title_full Diagnostic considerations for gastrointestinal stromal tumors with altered immunophenotype following Imatinib treatment: A case report and literature review
title_fullStr Diagnostic considerations for gastrointestinal stromal tumors with altered immunophenotype following Imatinib treatment: A case report and literature review
title_full_unstemmed Diagnostic considerations for gastrointestinal stromal tumors with altered immunophenotype following Imatinib treatment: A case report and literature review
title_short Diagnostic considerations for gastrointestinal stromal tumors with altered immunophenotype following Imatinib treatment: A case report and literature review
title_sort diagnostic considerations for gastrointestinal stromal tumors with altered immunophenotype following imatinib treatment a case report and literature review
topic Gastrointestinal stromal tumors (GISTs)
CD117
DOG1
Imatinib
c-KIT
Immunohistochemistry
url http://www.sciencedirect.com/science/article/pii/S2772736X25000088
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