Gastrointestinal Tract

  • Peter Spieler
  • Matthias Rössle
Part of the Essentials of Diagnostic Pathology book series (ESSENTPATH)

Abstract

Main interest is directed towards Barrett’s esophagus, and premalignant squamous and adenomatous esophageal disorders including impact of additional analyses, such as DNA ploidy and molecular genetics. Furthermore, cytology and ancillary tests of ‘gastrointestinal stromal tumor’ and ‘sacral chordoma’ are highlighted in particular.

Diagnostic algorithms of benign and malignant findings in cytologic specimens and respective differential diagnoses are additionally presented in a synoptic setup.

Keywords

Esophageal Squamous Cell Carcinoma Anal Canal Gastrointestinal Stromal Tumor Eosinophilic Esophagitis Cytologic Diagnosis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Further Reading

  1. 1.
    Anand D, Barroeta JE, Gupta PK, et al. Endoscopic ultrasoundguided fine-needle aspiration of non-pancreatic lesions: an institutional experience. J Clin Pathol 2007;60:1254-1262.PubMedCrossRefGoogle Scholar
  2. 2.
    Ando N, Goto H, Niwa Y, et al. The diagnosis of GI stromal tumors with EUS-guided fine needle aspiration with immunohistochemical analysis. Gastrointest Endosc 2002;55:37-43.PubMedCrossRefGoogle Scholar
  3. 3.
    Barr Fritcher EG, Brankley SM, Kipp BR et al. A comparison of conventional cytology, DNA ploidy analysis, and fluorescence in situ hybridization for the detection of dysplasia and adenocarcinoma in patients with Barrett’s esophagus Human Pathology 2008; 39:1128–1135.CrossRefGoogle Scholar
  4. 4.
    Berman J, O’Leary TJ. Gastrointestinal tumor workshop. Human Pathol 2001;32:578-582.CrossRefGoogle Scholar
  5. 5.
    Binek J, Spieler P, Hürlimann R, et al. Ultrasound-guided fineneedle aspiration of abdominal masses: Accuracy and short-term complications. Europ J Ultrasound 1995;2:199-203.CrossRefGoogle Scholar
  6. 6.
    Blant SA, Ballini JP, Caron CT, et al. Evolution of DNA ploidy during squamous cell carcinogenesis in the esophagus. Dis Esophagus 2001;14:178-184.PubMedCrossRefGoogle Scholar
  7. 7.
    Boller DA, Borovicka J, Spieler P, et al. Lugol chromoendoscopy combined with image cytometry and p53 LOH in patients at risk for esophageal squamous cell carcinoma. Gastrointest Endosc 2006;63:S1520.CrossRefGoogle Scholar
  8. 8.
    Boller D, Spieler P, Schoenegg R, et al. Lugol chromoendoscopy combined with brush cytology in patients at risk for esophageal squamous cell carcinoma. Surg Endoscop 2009;23:2748-2754.CrossRefGoogle Scholar
  9. 9.
    Boettger T, Störkel S, Stöckle M, et al. DNA image cytometry. A prognostic tool in squamous cell carcinoma of the esophagus? Cancer 1991;67:2290-2294.CrossRefGoogle Scholar
  10. 10.
    Boettger T, Dutkowski P, Kirkpatrick CJ, et al. Prognostic relevance of histomorphological parameters and DNA content and their therapeutic consequences in esophageal carcinoma: a multivariate approach. Hepatogastroenterology 1998;45:994-1004.PubMedGoogle Scholar
  11. 11.
    Borovicka J, Schoenegg R, Hell M, Spieler P. et al. Is there an advantage to be gained from adding digital image cytometry of brush cytology to a standard biopsy protocol in patients with Barrett’s esophagus? Endoscopy 2009;41:409-414.PubMedCrossRefGoogle Scholar
  12. 12.
    Buratti S, Savides TJ, Newbury RO, Dohil R. Granular cell tumor of the esophagus: report of a pediatric case and literature review. J Pediatr Gastroenterol Nutr 2004;38:97-101.PubMedCrossRefGoogle Scholar
  13. 13.
    Chandan VS, Murray JA, Abraham SC. Esophageal lichen planus. Arch Pathol Lab Med 2008;132:1026-1029.PubMedGoogle Scholar
  14. 14.
    Chatzipantelis P, Salla C, Karoumpalis I, et al. Endoscopic ultrasound-guided fine needle aspiration biopsy in the diagnosis of gastrointestinal stromal tumors of the stomach. A study of 17 cases. J Gastrointestin Liver Dis 2008;17:15-20.PubMedGoogle Scholar
  15. 15.
    Chehade M, Sampson HA. Epidemiology and etiology of eosinophilic esophagitis. Gastrointest Endosc Clin N Am 2008;18:33-44;viii.PubMedCrossRefGoogle Scholar
  16. 16.
    Chen VK, Eloubeidi MA. Endoscopic ultrasound guided fine needle aspiration of intramural and extraintestinal mass lesions: diagnostic accuracy, complication assessment, and impact on management. Endoscopy 2005;37:984-989.PubMedCrossRefGoogle Scholar
  17. 17.
    Chhieng DC, Jhala D, Jhala N, et al. Endoscopic ultrasound-guided fine-needle aspiration biopsy: a study of 103 cases. Cancer 2002;96:232-239.PubMedCrossRefGoogle Scholar
  18. 18.
    Choong CK, Meyers BF. Benign esophageal tumors: introduction, incidence, classification, and clinical features. Semin Thorac Cardiovasc Surg 2003;15:3-8.PubMedCrossRefGoogle Scholar
  19. 19.
    Conio M, Bianchi S, Lapertosa G, et al. Long-term endoscopic surveillance of patients with Barrett’s esophagus. Incidence of dysplasia and adenocarcinoma: a prospective study. Am J Gastroenterol 2003;98:1931-1939.PubMedCrossRefGoogle Scholar
  20. 20.
    Defrain C, Chang CY, Srikureja W, et al. Cytologic features and diagnostic pitfalls of primary ampullary tumors by endoscopic ultrasound-guided fine-needle aspiration biopsy. Cancer 2005;105:289-297.PubMedCrossRefGoogle Scholar
  21. 21.
    de Ruiter A, Carter P, Katz DR, et al. A comparison between cytology and histology to detect anal intraepithelial neoplasia. Genitourin Med 1994;70:22-25.PubMedGoogle Scholar
  22. 22.
    Doki Y, Shiozaki H, Tahara H, et al. Prognostic value of DNA ploidy in squamous cell carcinoma of esophagus. Analyzed with improved flow cytometric measurement. Cancer 1993;72:1813-1818.PubMedCrossRefGoogle Scholar
  23. 23.
    Dong Q, McKee G, Pitman M, et al. Epithelioid variant of gastrointestinal stromal tumor: diagnosis by fine needle aspiration. Diagn Cytopathol 2003;29:55-60.PubMedCrossRefGoogle Scholar
  24. 24.
    Dorman AM, Walsh TN, Droogan O, et al. DNA quantification of squamous cell carcinoma of the esophagus by flow cytometry and cytophotometric image analysis using formalin fixed paraffin embedded tissue. Cytometry 1992;13:886-892.PubMedCrossRefGoogle Scholar
  25. 25.
    Drewitz DJ, Sampliner RE, Garewal HS. The incidence of adenocarcinoma in Barrett’s esophagus: a prospective study of 170 patients followed 4.8 years. Am J Gastroenterol 1997;92:212-215.PubMedGoogle Scholar
  26. 26.
    Elliott DD, Fanning CV, Caraway NP. The utility of fine-needle aspiration in the diagnosis of gastrointestinal stromal tumors: a cytomorphologic and immunohistochemical analysis with emphasis on malignant tumors. Cancer 2006;108:49-55.PubMedCrossRefGoogle Scholar
  27. 27.
    Fang M, Lew E, Klein M, et al. DNA abnormalities as marker of risk for progression of Barrett’s esophagus to adenocarcinoma: image cytometric DNA analysis in formalin-fixed tissues. Am J Gastroenterol 2004;99:1887-1894.PubMedCrossRefGoogle Scholar
  28. 28.
    Fernandez-Esparrach G, Gines A, Belda J, et al. Transesophageal ultrasound-guided fine needle aspiration improves mediastinal staging in patients with non-small cell lung cancer and normal mediastinum on computed tomography. Lung Cancer 2006;54:35-40.PubMedCrossRefGoogle Scholar
  29. 29.
    Finley JL, Silverman JF; Dabbs DJ, et al. Chordoma: diagnosis by fine-needle aspiration biopsy with histologic, immunocytochemical, and ultrastructural confirmation. Diagn Cytopathol 1986;2:330-337.PubMedCrossRefGoogle Scholar
  30. 30.
    Fireman Z, Kopelman Y. New frontiers in capsule endoscopy. J Gastroenterol Hepatol 2007;22:1174-1177.PubMedCrossRefGoogle Scholar
  31. 31.
    Fléjou JF Barrett’s oesophagus: from metaplasia to dysplasia and cancer. Gut 2005;54 Suppl 1:i6-12.PubMedCrossRefGoogle Scholar
  32. 32.
    Fox PA, Seet JE, Stebbing J, et al. The value of anal cytology and human papilloma virus typing in the detection of anal intraepithelial neoplasia: a review of cases from an anoscopy clinic. Sex Transm Infect 2005;81:142-146.PubMedCrossRefGoogle Scholar
  33. 33.
    Franzén S, Giertz G, Zajicek J. Cytological diagnosis of prostatic tumours by transrectal aspiration biopsy: a preliminary report. Br J Urol 1960;32:193-196.PubMedCrossRefGoogle Scholar
  34. 34.
    Fu K, Eloubeidi MA, Jhala NC, et al. Diagnosis of gastrointestinal stromal tumor by endoscopic ultrasound-guided fine needle aspiration biopsy - a potential pitfall. Ann Diagn Pathol 2002;6:294-301.PubMedCrossRefGoogle Scholar
  35. 35.
    Furuta GT, Liacouras CA, Collins MH, et al. Eosinophilic esophagitis in children and adults: a systematic review and consensus recommendations for diagnosis and treatment. Gastroenterology 2007;133:1342-1363.PubMedCrossRefGoogle Scholar
  36. 36.
    Galipeau PC, Li X, Blount PL, et al. NSAIDs modulate CDKN2A, TP53, and DNA content risk for progression to esophageal adenocarcinoma. PloS Med 2007;4:e67.PubMedCrossRefGoogle Scholar
  37. 37.
    Gottlieb K, Lin PH, Liu DM, Anders K. Transrectal EUS-guided FNA biopsy of a presacral chordoma - report of a case and review of the literature. World J Gastroenterol 2008;14:2586-2589.PubMedCrossRefGoogle Scholar
  38. 38.
    Günter E. Transesophageal ultrasonography for mediastinum diagnostics. Chirurg 2008;79:56-60.PubMedCrossRefGoogle Scholar
  39. 39.
    Hamilton SR, Aaltonen LA. World Health Organization Classification of Tumours. Pathology and Genetics of Tumours of the Digestive System. IARC Press:Lyon 2000.Google Scholar
  40. 40.
    Herth FJ, Rabe KF, Gasparini S, Annema JT. Transbronchial and transoesophageal (ultrasound-guided) needle aspirations for the analysis of mediastinal lesions. Eur Respir J 2006;28:1264-1275.PubMedCrossRefGoogle Scholar
  41. 41.
    Husain OAN. Alimentary tract (esophagus, stomach, colon, rectum) In: M.Bibbo (Ed) Comprehensive Cytopathology . W.B. Saunders Comp, 1991.Google Scholar
  42. 42.
    Ikebe M, Kitamura K, Baba K, et al. DNA ploidy as a prognostic factor in early esophageal carcinoma. Hepatogastroenterology 1993;40:232-235.PubMedGoogle Scholar
  43. 43.
    James PD, Atkinson M. Value of DNA image cytometry in the prediction of malignant change in Barrett’s oesophagus. Gut 1989;30:899-905.PubMedCrossRefGoogle Scholar
  44. 44.
    Jenkins CN, Colquhoun IR. Case report: symptomatic metastasis from a sacrococcygeal chordoma. Clin Radiol 1995;50:416-417.PubMedCrossRefGoogle Scholar
  45. 45.
    Jhala NC, Jhala D, Eltoum I, et al. Endoscopic ultrasound-guided fine-needle aspiration biopsy: a powerful tool to obtain samples from small lesions. Cancer 2004;102:203-206.CrossRefGoogle Scholar
  46. 46.
    Kay PA, Nascimento AG, Unni KK, Salomao DR. Chordoma. Cytomorphologic findings in 14 cases diagnosed by fine needle aspiration. Acta Cytol 2003;47:202-208.PubMedCrossRefGoogle Scholar
  47. 47.
    Keller R, Brandt B, Terpe HJ, et al. Cytology and image cytometry after colonic lavage: a complementary diagnostic tool in patients with ulcerative colitis. Dig Liver Dis 2003;35:24-31.PubMedCrossRefGoogle Scholar
  48. 48.
    Koh JS, Trent J, Chen L, et al. Gastrointestinal stromal tumors: overview of pathologic features, molecular biology, and therapy with imatinib mesylate. Histol Histopathol 2004;19:565-574.PubMedGoogle Scholar
  49. 49.
    Kontogianni-Katsarou K, Lariou C, Tsompanaki E, et al. KIT-negative gastrointestinal stromal tumors with a long term follow-up: a new subgroup does exist. World J Gastroenterol 2007;13:1098-1102.PubMedGoogle Scholar
  50. 50.
    Krishnadath KK, Reid BJ, Wang KK. Biomarkers in Barrett esophagus Mayo Clin Proc 2001;76:438-446.PubMedGoogle Scholar
  51. 51.
    Lack EE. Pathology of the extrahepatic biliary tract and ampullary region. in: Pathology of the Pancreas, Gallbladder, Extrahepatic Biliary Tract, and Ampullary Region. Oxford University Press, Inc. 2003.Google Scholar
  52. 52.
    Laforga JB. Malignant epithelioid gastrointestinal stromal tumors: report of a case with cytologic and immunohistochemical studies. Acta Cytol 2005;49:435-440.PubMedCrossRefGoogle Scholar
  53. 53.
    Levine DS, Rabinovitch PS, Haggitt RC, et al. Distribution of aneuploid cell populations in ulcerative colitis with dysplasia or cancer. Gastroenterology 1991;101:1198-1210.PubMedGoogle Scholar
  54. 54.
    Li SQ, O’Leary TJ, Buchner SB, et al. Fine needle aspiration of gastrointestinal stromal tumors. Acta Cytol 2001;45:9-17.PubMedCrossRefGoogle Scholar
  55. 55.
    Lindberg JO, Stenling RB, Rutegard JN. DNA aneuploidy as a marker of premalignancy in surveillance of patients with ulcerative colitis. Br J Surg 1999;86:947-950.PubMedCrossRefGoogle Scholar
  56. 56.
    Löfberg R. Studies in longstanding ulcerative colitis with special reference to malignant transformation of the colorectal mucosa. Acta Chir Scand Suppl 1989;552:1-45.PubMedGoogle Scholar
  57. 57.
    Logrono R, Bhanot P, Chaya C, et al. Imaging, morphologic, and immunohistochemical correlation in gastrointestinal stromal tumors. Cancer 2006;108:257-266.PubMedCrossRefGoogle Scholar
  58. 58.
    Markowitz J, McKinley M, Kahn E, et al. Endoscopic screening for dysplasia and mucosal aneuploidy in adolescents and young adults with childhood onset colitis. Am J Gastroenterol 1997;92:2001-2006.PubMedGoogle Scholar
  59. 59.
    Menke-Pluymers MB, Hop WC, Mulder AH, Tilanus HW. DNA ploidy as a prognostic factor for patients with an adenocarcinoma in Barrett’s esophagus. Hepatogastroenterology 1995;42:786-788.PubMedGoogle Scholar
  60. 60.
    Miettinen M, Lasota J. Gastrointestinal stromal tumors review on morphology, molecular pathology, prognosis, and differential diagnosis. Arch Pathol Lab Med 2006;130:1466–1478.PubMedGoogle Scholar
  61. 61.
    Miettinen M, Sobin LH, Lasota J. Gastrointestinal stromal tumor of the stomach: a clinicopathologic, immunohistochemical, and molecular genetic study of 1765 cases with long-term follow-up. Am J Surg Pathol 2005;29:52-68.PubMedCrossRefGoogle Scholar
  62. 62.
    Nijhawan VS, Rajwanshi A, Das A, et al. Fine-needle aspiration cytology of sacrococcygeal chordoma. Diagn Cytopathol 1989;5:404-407.PubMedCrossRefGoogle Scholar
  63. 63.
    Oberhuber G. Histology of Crohn disease-type lesions in the upper gastrointestinal tract. Pathologe 2001;22:91-96.PubMedCrossRefGoogle Scholar
  64. 64.
    O’Toole D, Palazzo L, Arotcarena R, et al. Assessment of complications of EUS-guided fine-needle aspiration. Gastrointest Endosc 2001;53:470-474.PubMedCrossRefGoogle Scholar
  65. 65.
    Pan Q-J, Roth MJ, Guo H-Q, et al. Cytologic detection of esophageal squamous cell carcinoma and its precursor lesions using balloon samplers and liquid-based cytology in asymptomatic adults in Linxian, China. Acta Cytol 2008;52:14-23.PubMedCrossRefGoogle Scholar
  66. 66.
    Perasole A, Infantolino D, Spigariol F. Aspiration cytology and immunocytochemistry of sacral chordoma with liver metastases: a case report. Diagn Cytopathol 1991;7:277-281.PubMedCrossRefGoogle Scholar
  67. 67.
    Plazza JA, Ballestin C, Perez-Barrios A, et al. Cytologic, cytochemical, immunocytochemical and ultrastructural diagnosis of a sacrococcygeal chordoma in a fine needle aspiration biopsy specimen. Acta Cytol 1989;33:89-92.Google Scholar
  68. 68.
    Prolla JC, Kirsner JB. Handbook and Atlas of Gastrointestinal Exfoliative Cytology. The University of Chicago Press, Chicago. 1972.Google Scholar
  69. 69.
    Rabenstein T, Krauss N, Hahn EG, Konturek P. Wireless capsule endoscopy – beyond the frontiers of flexible gastrointestinal endoscopy. Med Sci Monit 2002;8:RA128-132.PubMedGoogle Scholar
  70. 70.
    Reid BJ, Blount PL, Rubin CE, et al. Flow-cytometric and histological progression to malignancy in Barrett’s esophagus: prospective endoscopic surveillance of a cohort. Gastroenterology 1992;102:1212-1219.PubMedGoogle Scholar
  71. 71.
    Reid BJ, Blount PL, Rabinovitch PS. Biomarkers in Barrett’s esophagus. Gastrointest Endosc Clin N Am 2003;13:369-397.PubMedCrossRefGoogle Scholar
  72. 72.
    Reid BJ, Levine DS, Longton G, et al. Predictors of progression to cancer in Barrett’s esophagus: baseline histology and flow cytometry identify low- and high-risk subsets. Am J Gastroenterol 2000;95:1669-1676.PubMedGoogle Scholar
  73. 73.
    Reid BJ, Prevo LJ, Galipeau PC, et al. Predictors of progression in Barrett’s esophagus II: baseline 17p (p53) loss of heterozygosity identifies a patient subset at increased risk for neoplastic progression. Am J Gastroenterol 2001;96:2839-2848.PubMedCrossRefGoogle Scholar
  74. 74.
    Rickes S, Hauptmann S, Flath B, et al. Development of a flow cytometric method to determine DNA ploidy of esophageal cancer cells obtained by forceps biopsy samples during esophago-gastroduodenoscopy. Onkologie 2003;26:32-37.PubMedCrossRefGoogle Scholar
  75. 75.
    Rubin BP, Heinrich MC, Corless CL. Gastrointestinal stromal tumour. Lancet 2007; 369:1731–1741.PubMedCrossRefGoogle Scholar
  76. 76.
    Ruol A, Segalin A, Panozzo M, et al. Flow cytometric DNA analysis of squamous cell carcinoma of the esophagus. Cancer 1990;65:1185-1188.PubMedCrossRefGoogle Scholar
  77. 77.
    Sarlomo-Rikala M, Kovatich AJ, Barusevicius A, Miettinen M. CD117: a sensitive marker for gastrointestinal stromal tumors that is more specific than CD34. Mod Pathol 1998;11:728-734.PubMedGoogle Scholar
  78. 78.
    Scarpa M, Bertin M, Ruffolo C, et al. A systematic review on the clinical diagnosis of gastrointestinal stromal tumors. J Surg Oncol 2008;98:384-392.PubMedCrossRefGoogle Scholar
  79. 79.
    Schmitz-Moormann P, Malchow H, Pittner PM. Endoscopic and bioptic study of the upper gastrointestinal tract in Crohn’s disease patients. Pathol Res Pract 1985;179:377-387.PubMedCrossRefGoogle Scholar
  80. 80.
    Scholefield JH, Johnson J, Hitchcock A, et al. Guidelines for anal cytology – to make cytologic diagnosis and follow-up much more reliable. Cytopathology 1998;9:15-22.PubMedCrossRefGoogle Scholar
  81. 81.
    Shami VM, Parmar KS, Waxman I. Clinical impact of endoscopic ultrasound and endoscopic ultrasound-guided fine-needle aspiration in the management of rectal carcinoma. Dis Colon Rectum 2004;47:59-65.PubMedCrossRefGoogle Scholar
  82. 82.
    Smith C, Butler JA. Efficacy of directed percutaneous fine-needle aspiration cytology in the diagnosis of intra-abdominal masses. Arch Surg 1988;123:820-824.PubMedCrossRefGoogle Scholar
  83. 83.
    Spiethoff A, Kakobs R, Martin WR, et al. DNA cytometric studies of Barrett mucosa. Med Klin (Munich) 2001;96:208-211.CrossRefGoogle Scholar
  84. 84.
    Stelow EB, Murad FM, Debol SM, et al. A limited immunocytochemical panel for the distinction of subepithelial gastrointestinal mesenchymal neoplasms sampled by endoscopic ultrasound-guided fine-needle aspiration. Am J Clin Pathol 2008;129: 219-225.PubMedCrossRefGoogle Scholar
  85. 85.
    Südhoff T, Hollerbach S, Wilhelms I, et al. Clinical utility of EUS-FNA in upper gastrointestinal and mediastinal disease. Dtsch med Wochenschr 2004;129:2227-2232.PubMedCrossRefGoogle Scholar
  86. 86.
    Swain P. The future of wireless capsule endoscopy. World J Gastroenterol 2008;14:4142-4145.PubMedCrossRefGoogle Scholar
  87. 87.
    Trupiano JK, Stewart RE, Misick C, et al. Gastric stromal tumors: a clinicopathologic study of 77 cases with correlation of features with nonaggressive and aggressive clinical behaviors. Am J Surg Pathol 2002;26:705-714.PubMedCrossRefGoogle Scholar
  88. 88.
    Vander Noot MR 3rd , Eloubeidi MA, Chen VK, et al. Diagnosis of gastrointestinal tract lesions by endoscopic ultrasound-guided fineneedle aspiration biopsy. Cancer 2004;102:157-163.PubMedCrossRefGoogle Scholar
  89. 89.
    Walaas L, Kindblom LG. Fine-needle aspiration biopsy in the preoperative diagnosis of chordoma: a study of 17 cases with application of electron microscopic, histochemical, and immunocytochemical examination. Hum Pathol 1991;22:22-28.PubMedCrossRefGoogle Scholar
  90. 90.
    Wang LD, Yang HH, Fan ZM, et al. Cytological screening and 15 years’ follow-up (1986–2001) for early esophageal squamous cell carcinoma and precancerous lesions in a high-risk population in Anyang County, Henan province, Northern China. Cancer Detect Prev 2005;29:317-322.PubMedCrossRefGoogle Scholar
  91. 91.
    Wardelmann E, Büttner R, Merkelbach-Bruse S, Schildhaus H-U. Mutation analysis of gastrointestinal stromal tumors: increasing significance for risk assessment and effective targeted therapy. Virchows Arch 2007;451:743-749.PubMedCrossRefGoogle Scholar
  92. 92.
    Wieczorek TJ, Faquin WC, Rubin BP, Cibas ES. Cytologic diagnosis of gastrointestinal stromal tumor with emphasis on the differential diagnosis with leiomyosarcoma. Cancer 2001;93:276-287.PubMedCrossRefGoogle Scholar
  93. 93.
    Yamaguchi K, Enjoji M. Adenoma of the ampulla of Vater: putative precancerous lesion. Gut 1991;32:1558-1561.PubMedCrossRefGoogle Scholar
  94. 94.
    Yang J, Du X, Lazar AJ, et al. Genetic aberrations of gastrointestinal stromal tumors. Cancer 2008;113:1532-1543.PubMedCrossRefGoogle Scholar
  95. 95.
    Yantiss RK, Spiro IJ, Compton CC, Rosenberg AE. Gastrointestinal stromal tumor versus intra-abdominal fibromatosis of the bowel wall: a clinically important differential diagnosis. Am J Surg Pathol 2000;24:947-957.PubMedCrossRefGoogle Scholar
  96. 96.
    Yu C, Zhang X, Huang Q, et al. High-fidelity DNA histograms in neoplastic progression in Barrett’s esophagus. Lab Invest 2007;87:466-472.PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  • Peter Spieler
    • 1
  • Matthias Rössle
    • 2
  1. 1.Institut für PathologieKantonsspital St. GallenSt. GallenSwitzerland
  2. 2.Institut für Klinische PathologieUniversitätsSpital ZürichZürichSwitzerland

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