Rectal Stromal Tumors: CT/MR Manifestation and Clinicopathologic Characteristics_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

LUO Xiaohua ¹ , SONG Bin ² , ZHUANG Xiongjie ¹ , WU Xiurong ¹ , RAO Mingyue ¹ , ZHANG Haifang. ³

1.Department of Radiology, The First Affiliated Hospital of Xiamen University, Xiamen 361003, Fujian Province, China;;
2.Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China;;
3.Department of Pathology, The First Affiliated Hospital of Xiamen University, Xiamen 361003, Fujian Province, China;

Corresponding author：

Keywords：

Rectal neoplasm; Gastrointestinal stromal tumors; X-ray tomography; Magnetic resonance; Pathology

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ObjectiveTo study the imaging manifestation and clinicopathologic characteristics of rectal stromal tumors. MethodsThe CT and MRI data of 8 patients with pathology proved rectal stromal tumors were retrospectively analyzed, and the correlation between the imaging features and pathological results were analyzed. ResultsAll of 8 cases were malignant. One case was submucosal. It showed irregular thickening of the rectal wall with a diameter of about 2.6 cm, and small ulcers with low-risk could be seen. Three cases were intramural with diameters of about 0.7－10.0 cm. Small lesion located in rectum, and the larger lesions showed internal and external growth across the rectal wall and the main part of the mass was outside the rectum. They were heterogeneous enhancement. One case accompanied with adenocarcinoma. One case was extremely low-risk, two cases were high-risk. Four cases were subserous. The diameter was about 4.2－16.5 cm. CT showed round or lobular, well-circumscribed, exophytic, hypervascular, and heterogeneous masses with cystic necrosis and hemorrhage. They displaced rectum occasionally. Lymphadenopathy in the left groin was developed in one case. Two cases were highrisk, two cases were intermediated-risk. No cases developed intestinal obstruction. Results of immunohistochemistry: CD117 was positive in 7 cases, CD34 positive in five cases, CD117 and CD34 positive in four cases, CD117 negative but CD34 positive in one case, CD117 positive but CD34 negative in three cases. Five cases were followed up, among whom 3 cases recurred. ConclusionsRectal stromal tumor is rare. Imaging appearances of rectal stromal tumors are specific. Its final diagnosis depends on immunohistochemistry examination. It has generally higher degree of malignancy and the prognosis is relatively poor.

Citation： LUO Xiaohua,SONG Bin,ZHUANG Xiongjie,WU Xiurong,RAO Mingyue,ZHANG Haifang.. Rectal Stromal Tumors: CT/MR Manifestation and Clinicopathologic Characteristics. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2011, 18(10): 1109-1113. doi: Copy

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2.	Joensuu H. Risk stratification of patients diagnosed with gastrointestinal stromal tumor [J]. Hum Pathol, 2008, 39(10): 14111419.
3.	Mazur MT, Clark HB. Gastric stromal tumors. Reappraisal of histogenesis [J]. Am J Surg Pathol, 1983, 7(6): 507519.
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5.	中国胃肠道间质瘤病理专家组．中国胃肠道间质瘤病理共识意见 [J]．中华病理学杂志， 2007， 36(10): 704707．.
6.	Hirota S, Isozaki K. Pathology of gastrointestinal stromal tumors [J]. Pathol Int, 2006, 56(1): 19.
7.	Corless CL, Heinrich MC. Molecular pathobiology of gastrointestinal stromal sarcomas [J]. Annu Rev Pathol, 2008, 3: 557586.
8.	龚静山，杨鹏，徐坚民，等．胃肠道间质瘤的CT和MRI诊断 [J]．临床放射学杂志， 2008， 27(1): 6265．.
9.	徐利军，文阳，王伯胤，等．多层螺旋CT对胃肠道间质瘤的诊断价值及临床病理分析 [J]．医学影像学杂志， 2009， 19(2): 165168．.
10.	朱玉春，周伟，张怀信，等．胃肠道间质瘤的螺旋CT征象与其恶性度的对照分析 [J]．临床放射学杂志， 2009， 28(10): 14121415．.
11.	Caramella T, Schmidt S, Chevallier P, et al. MR features of gastrointestinal stromal tumors [J]. Clin Imaging, 2005, 29(4): 251254.
12.	Yang BL, Gu YF, Shao WJ, et al. Retrorectal tumors in adults: magnetic resonance imaging findings [J]. World J Gastroenterol, 2010, 16(46): 58225829.
13.	Kochhar R, Manoharan P, Leahy M, et al. Imaging in gastrointestinal stromal tumours: current status and future directions [J]. Clin Radiol, 2010, 65(8): 584592.
14.	吴苾，宋彬．影像学新技术在消化系统的临床应用 [J]．中国普外基础与临床杂志， 2007， 14(2): 222229．.
15.	Dematteo RP, Heinrich MC, ElRifai WM, et al. Clinical management of gastrointestinal stromal tumors: Before and after STI571 [J]. Hum Pathol, 2002, 33(5): 466477.

1. Ploner F, Zacherl J, Wrba F, et al. Gastrointestinal stromal tumors: Recommendations on diagnosis, therapy and followup care in Austria [J]. Wien Klin Wochenschr, 2009, 121(2324): 780790.
2. Joensuu H. Risk stratification of patients diagnosed with gastrointestinal stromal tumor [J]. Hum Pathol, 2008, 39(10): 14111419.
3. Mazur MT, Clark HB. Gastric stromal tumors. Reappraisal of histogenesis [J]. Am J Surg Pathol, 1983, 7(6): 507519.
4. Dow N, Giblen G, Sobin LH, et al. Gastrointestinal stromal tumors: differential diagnosis [J]. Semin Diagn Pathol, 2006, 23(2): 111119.
5. 中国胃肠道间质瘤病理专家组．中国胃肠道间质瘤病理共识意见 [J]．中华病理学杂志， 2007， 36(10): 704707．.
6. Hirota S, Isozaki K. Pathology of gastrointestinal stromal tumors [J]. Pathol Int, 2006, 56(1): 19.
7. Corless CL, Heinrich MC. Molecular pathobiology of gastrointestinal stromal sarcomas [J]. Annu Rev Pathol, 2008, 3: 557586.
8. 龚静山，杨鹏，徐坚民，等．胃肠道间质瘤的CT和MRI诊断 [J]．临床放射学杂志， 2008， 27(1): 6265．.
9. 徐利军，文阳，王伯胤，等．多层螺旋CT对胃肠道间质瘤的诊断价值及临床病理分析 [J]．医学影像学杂志， 2009， 19(2): 165168．.
10. 朱玉春，周伟，张怀信，等．胃肠道间质瘤的螺旋CT征象与其恶性度的对照分析 [J]．临床放射学杂志， 2009， 28(10): 14121415．.
11. Caramella T, Schmidt S, Chevallier P, et al. MR features of gastrointestinal stromal tumors [J]. Clin Imaging, 2005, 29(4): 251254.
12. Yang BL, Gu YF, Shao WJ, et al. Retrorectal tumors in adults: magnetic resonance imaging findings [J]. World J Gastroenterol, 2010, 16(46): 58225829.
13. Kochhar R, Manoharan P, Leahy M, et al. Imaging in gastrointestinal stromal tumours: current status and future directions [J]. Clin Radiol, 2010, 65(8): 584592.
14. 吴苾，宋彬．影像学新技术在消化系统的临床应用 [J]．中国普外基础与临床杂志， 2007， 14(2): 222229．.
15. Dematteo RP, Heinrich MC, ElRifai WM, et al. Clinical management of gastrointestinal stromal tumors: Before and after STI571 [J]. Hum Pathol, 2002, 33(5): 466477.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Rectal Stromal Tumors: CT/MR Manifestation and Clinicopathologic Characteristics

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