{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T22:26:20Z","timestamp":1783635980381,"version":"3.55.0"},"reference-count":66,"publisher":"Archives of Pathology and Laboratory Medicine","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2016,10]]},"abstract":"Spindle cell lesions of the gastrointestinal tract are relatively uncommon compared with the frequency of their epithelial counterparts. Although gastrointestinal stromal tumors and leiomyomas are the most commonly encountered spindle cell lesions in the stomach and esophagus, respectively, there are other less common diagnostic entities that should be considered for accurate diagnoses as well as appropriate patient treatment and clinical follow-up. Given the morphologic overlap of low-grade spindle cell lesions on cytologic preparations, ancillary studies play a key role in differentiating these lesions from one another.<\/jats:p>","DOI":"10.5858\/arpa.2016-0235-ra","type":"journal-article","created":{"date-parts":[[2016,9,29]],"date-time":"2016-09-29T09:14:32Z","timestamp":1475140472000},"page":"1038-1044","source":"Crossref","is-referenced-by-count":15,"title":["Cytologic and Immunohistochemical Evaluation of Low-Grade Spindle Cell Lesions of the Gastrointestinal Tract"],"prefix":"10.5858","volume":"140","author":[{"given":"Nilam","family":"Virani","sequence":"first","affiliation":[{"name":"From the Department of Pathology, University of Michigan, Ann Arbor."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judy","family":"Pang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madelyn","family":"Lew","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3906","reference":[{"issue":"2","key":"i1543-2165-140-10-1038-b01","series-title":"Virchows Arch","first-page":"111","article-title":"Gastrointestinal stromal tumors","volume":"456","author":"Liegl-Atwanger \n B,","year":"2010","unstructured":"Liegl-Atwanger \n B, \n \n \n Fletcher \n JA, \n \n \n Fletcher \n CD. \n \n \n Gastrointestinal stromal tumors. 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Am J Surg Pathol. 2008;32(2):210\u2013218."},{"issue":"7","key":"i1543-2165-140-10-1038-b09","series-title":"J Clin Pathol","first-page":"613","article-title":"V600E BRAF mutations are alternative early molecular events in a subset of KIT\/PDGFRA wild-type gastrointestinal stromal tumours","volume":"62","author":"Agaimy \n A,","year":"2009","unstructured":"Agaimy \n A, \n \n \n Terracciano \n LM, \n \n \n Dirnhofer \n S, \n \n et al. \n V600E BRAF mutations are alternative early molecular events in a subset of KIT\/PDGFRA wild-type gastrointestinal stromal tumours. 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Am J Clin Pathol. 2010;133(1):141\u2013148."},{"issue":"10","key":"i1543-2165-140-10-1038-b12","series-title":"Mod Pathol","first-page":"950","article-title":"Mesenchymal tumors of muscularis mucosae of colon and rectum are benign leiomyomas that should be separated from gastrointestinal stromal tumors\u2014a clinicopathologic and immunohistochemical study of eighty-eight cases","volume":"14","author":"Miettinen \n M,","year":"2001","unstructured":"Miettinen \n M, \n \n \n Sarlomo-Rikala \n M, \n \n \n Sobin \n LH. \n \n \n Mesenchymal tumors of muscularis mucosae of colon and rectum are benign leiomyomas that should be separated from gastrointestinal stromal tumors\u2014a clinicopathologic and immunohistochemical study of eighty-eight cases. Mod Pathol. 2001;14(10):950\u2013956."},{"issue":"1","key":"i1543-2165-140-10-1038-b13","series-title":"Arch Pathol Lab Med","first-page":"134","article-title":"Gastrointestinal stromal tumors: a review of the literature","volume":"134","author":"Laurini \n JA,","year":"2010","unstructured":"Laurini \n JA, \n \n \n Carter \n JE. \n \n \n Gastrointestinal stromal tumors: a review of the literature. Arch Pathol Lab Med. 2010;134(1):134\u2013141."},{"issue":"10","key":"i1543-2165-140-10-1038-b14","series-title":"Mod Pathol","first-page":"1134","article-title":"Immunohistochemical spectrum of GISTs at different sites and their differential diagnosis with a reference to CD117 (KIT)","volume":"13","author":"Miettinen \n M,","year":"2000","unstructured":"Miettinen \n M, \n \n \n Sobin \n LH, \n \n \n Sarlomo-Rikala \n M. \n \n \n Immunohistochemical spectrum of GISTs at different sites and their differential diagnosis with a reference to CD117 (KIT). Mod Pathol. 2000;13(10):1134\u20131142."},{"issue":"9","key":"i1543-2165-140-10-1038-b15","series-title":"Arch Pathol Lab Med","first-page":"1370","article-title":"Best practices in diagnostic immunohistochemistry: spindle cell neoplasms of the gastrointestinal tract","volume":"133","author":"Turner \n MS,","year":"2009","unstructured":"Turner \n MS, \n \n \n Goldsmith \n JD. \n \n \n Best practices in diagnostic immunohistochemistry: spindle cell neoplasms of the gastrointestinal tract. 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Am J Surg Pathol. 2010;34(1):53\u201364."},{"issue":"7","key":"i1543-2165-140-10-1038-b18","series-title":"Am J Surg Pathol","first-page":"846","article-title":"Schwannomas in the colon and rectum: a clinicopathologic and immunohistochemical study of 20 cases","volume":"25","author":"Miettinen \n M,","year":"2001","unstructured":"Miettinen \n M, \n \n \n Shekitka \n KM, \n \n \n Sobin \n LH. \n \n \n Schwannomas in the colon and rectum: a clinicopathologic and immunohistochemical study of 20 cases. Am J Surg Pathol. 2001;25(7):846\u2013855."},{"issue":"4","key":"i1543-2165-140-10-1038-b19","series-title":"Am J Surg Pathol","first-page":"431","article-title":"Benign schwannoma of the digestive tract: a clinicopathologic and immunohistochemical study of five cases, including a case of esophageal tumor","volume":"23","author":"Prevot \n S,","year":"1999","unstructured":"Prevot \n S, \n \n \n Bienvenu \n L, \n \n \n Vaillant \n JC, \n \n et al. \n Benign schwannoma of the digestive tract: a clinicopathologic and immunohistochemical study of five cases, including a case of esophageal tumor. Am J Surg Pathol. 1999;23(4):431\u2013436."},{"issue":"3","key":"i1543-2165-140-10-1038-b20","series-title":"Cancer Cytopathol","first-page":"171","article-title":"Cytomorphologic features that distinguish schwannoma from other low-grade spindle cell lesions","volume":"123","author":"Chebib \n I,","year":"2015","unstructured":"Chebib \n I, \n \n \n Hornicek \n FJ, \n \n \n Nielsen \n GP, \n \n \n Deshpande \n V. \n \n \n Cytomorphologic features that distinguish schwannoma from other low-grade spindle cell lesions. Cancer Cytopathol. 2015;123(3):171\u2013178."},{"issue":"9","key":"i1543-2165-140-10-1038-b21","series-title":"Am J Surg Pathol","first-page":"1291","article-title":"Sox10: a pan-schwannian and melanocytic marker","volume":"32","author":"Nonaka \n D,","year":"2008","unstructured":"Nonaka \n D, \n \n \n Chiriboga \n L, \n \n \n Rubin \n BP. \n \n \n Sox10: a pan-schwannian and melanocytic marker. Am J Surg Pathol. 2008;32(9):1291\u20131298."},{"issue":"2","key":"i1543-2165-140-10-1038-b22","series-title":"Am J Clin Pathol","first-page":"188","article-title":"Immunohistochemical staining for KIT (CD117) in soft tissue sarcomas is very limited in distribution","volume":"117","author":"Hornick \n JK.","year":"2002","unstructured":"Hornick \n JK. \n \n \n Fletcher \n CD. \n \n \n Immunohistochemical staining for KIT (CD117) in soft tissue sarcomas is very limited in distribution. Am J Clin Pathol. 2002;117(2):188\u2013193."},{"issue":"1","key":"i1543-2165-140-10-1038-b23","series-title":"Mod Pathol","first-page":"115","article-title":"Keratin expression in schwannoma; a study of 115 retroperitoneal and 22 peripheral schwannomas","volume":"19","author":"Fanburg-Smith \n JC,","year":"2006","unstructured":"Fanburg-Smith \n JC, \n \n \n Majidi \n M, \n \n \n Miettinen \n M. \n \n \n Keratin expression in schwannoma; a study of 115 retroperitoneal and 22 peripheral schwannomas. Mod Pathol. 2006;19(1):115\u2013121."},{"issue":"7","key":"i1543-2165-140-10-1038-b24","series-title":"Am J Surg Pathol","first-page":"947","article-title":"Gastrointestinal stromal tumor versus intra-abdominal fibromatosis of the bowel wall: a clinically important differential diagnosis","volume":"24","author":"Yantiss \n RK,","year":"2000","unstructured":"Yantiss \n RK, \n \n \n Spiro \n IJ, \n \n \n Compton \n CC, \n \n \n Rosenberg \n AE. \n \n \n Gastrointestinal stromal tumor versus intra-abdominal fibromatosis of the bowel wall: a clinically important differential diagnosis. Am J Surg Pathol. 2000;24(7):947\u2013957."},{"issue":"4","key":"i1543-2165-140-10-1038-b25","series-title":"Am J Surg Pathol","first-page":"549","article-title":"Are desmoid tumors KIT positive?","volume":"25","author":"Miettinen \n M.","year":"2001","unstructured":"Miettinen \n M. \n \n \n Are desmoid tumors KIT positive?\n Am J Surg Pathol. 2001;25(4):549\u2013550."},{"issue":"3","key":"i1543-2165-140-10-1038-b26","series-title":"Surg Pathol Clin","first-page":"425","article-title":"Mesenchymal tumors of the gastrointestinal tract other than GIST","volume":"6","author":"Doyle \n LA,","year":"2013","unstructured":"Doyle \n LA, \n \n \n Hornick \n JL. \n \n \n Mesenchymal tumors of the gastrointestinal tract other than GIST. 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Am J Surg Pathol. 2001;25(11):1364\u20131371."},{"issue":"12","key":"i1543-2165-140-10-1038-b29","series-title":"Cancer Res","first-page":"2776","article-title":"Recurrent involvement of 2p23 in inflammatory myofibroblastic tumors","volume":"59","author":"Griffin \n CA,","year":"1999","unstructured":"Griffin \n CA, \n \n \n Hawkins \n AL, \n \n \n Dvork \n C, \n \n et al. \n Recurrent involvement of 2p23 in inflammatory myofibroblastic tumors. Cancer Res. 1999;59(12):2776\u20132780."},{"issue":"1","key":"i1543-2165-140-10-1038-b30","series-title":"Mod Pathol","first-page":"68","article-title":"Nuclear beta-catenin in mesenchymal tumors","volume":"18","author":"Ng \n TL,","year":"2005","unstructured":"Ng \n TL, \n \n \n Gown \n AM, \n \n \n Barry \n TS, \n \n et al. \n Nuclear beta-catenin in mesenchymal tumors. 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Histopathology. 2007;51(4):509\u2013514."},{"issue":"5","key":"i1543-2165-140-10-1038-b32","series-title":"Am J Clin Pathol","first-page":"672","article-title":"Extensive survey of STAT6 expression in a large series of mesenchymal tumors","volume":"143","author":"Demicco \n EG,","year":"2015","unstructured":"Demicco \n EG, \n \n \n Harms \n PW, \n \n \n Patel \n RM, \n \n et al. \n Extensive survey of STAT6 expression in a large series of mesenchymal tumors. Am J Clin Pathol. 2015;143(5):672\u2013682."},{"issue":"9","key":"i1543-2165-140-10-1038-b33","series-title":"Am J Surg Pathol","first-page":"1401","article-title":"DOG1 antibody in the differential diagnosis of gastrointestinal stromal tumors: a study of 1840 cases","volume":"33","author":"Miettinen \n M,","year":"2009","unstructured":"Miettinen \n M, \n \n \n Wang \n ZF, \n \n \n Lasota \n J. \n \n \n DOG1 antibody in the differential diagnosis of gastrointestinal stromal tumors: a study of 1840 cases. Am J Surg Pathol. 2009;33(9):1401\u20131408."},{"issue":"2","key":"i1543-2165-140-10-1038-b01","series-title":"Virchows Arch","first-page":"111","article-title":"Gastrointestinal stromal tumors","volume":"456","author":"Liegl-Atwanger \n B,","year":"2010","unstructured":"Liegl-Atwanger \n B, \n \n \n Fletcher \n JA, \n \n \n Fletcher \n CD. \n \n \n Gastrointestinal stromal tumors. Virchows Arch. 2010;456(2):111\u2013127."},{"issue":"4","key":"i1543-2165-140-10-1038-b02","series-title":"Mod Pathol","first-page":"366","article-title":"Gastrointestinal stromal tumors and other mesenchymal lesions of the gut","volume":"17","author":"Greenson \n JK.","year":"2003","unstructured":"Greenson \n JK. \n \n \n Gastrointestinal stromal tumors and other mesenchymal lesions of the gut. Mod Pathol. 2003;17(4):366\u2013375."},{"issue":"5","key":"i1543-2165-140-10-1038-b03","series-title":"Hum Pathol","first-page":"478","article-title":"H L Sobin L, Lasota J. 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J Clin Pathol. 2009;62(7):613\u2013616."},{"issue":"10","key":"i1543-2165-140-10-1038-b10","series-title":"Genes Chromosomes Cancer","first-page":"853","article-title":"Novel V600E BRAF mutations in imatinib-na\u00efve and imatinib-resistant gastrointestinal stromal tumors","volume":"47","author":"Agaram \n NP,","year":"2008","unstructured":"Agaram \n NP, \n \n \n Wong \n GC, \n \n \n Guo \n T, \n \n et al. \n Novel V600E BRAF mutations in imatinib-na\u00efve and imatinib-resistant gastrointestinal stromal tumors. Genes Chromosomes Cancer. 2008;47(10):853\u2013859."},{"issue":"1","key":"i1543-2165-140-10-1038-b11","series-title":"Am J Clin Pathol","first-page":"141","article-title":"BRAF mutation status in gastrointestinal stromal tumors","volume":"133","author":"Hostein \n I,","year":"2010","unstructured":"Hostein \n I, \n \n \n Faur \n N, \n \n \n Promois \n C, \n \n et al. \n BRAF mutation status in gastrointestinal stromal tumors. 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Mod Pathol. 2001;14(10):950\u2013956."},{"issue":"1","key":"i1543-2165-140-10-1038-b13","series-title":"Arch Pathol Lab Med","first-page":"134","article-title":"Gastrointestinal stromal tumors: a review of the literature","volume":"134","author":"Laurini \n JA,","year":"2010","unstructured":"Laurini \n JA, \n \n \n Carter \n JE. \n \n \n Gastrointestinal stromal tumors: a review of the literature. Arch Pathol Lab Med. 2010;134(1):134\u2013141."},{"issue":"10","key":"i1543-2165-140-10-1038-b14","series-title":"Mod Pathol","first-page":"1134","article-title":"Immunohistochemical spectrum of GISTs at different sites and their differential diagnosis with a reference to CD117 (KIT)","volume":"13","author":"Miettinen \n M,","year":"2000","unstructured":"Miettinen \n M, \n \n \n Sobin \n LH, \n \n \n Sarlomo-Rikala \n M. \n \n \n Immunohistochemical spectrum of GISTs at different sites and their differential diagnosis with a reference to CD117 (KIT). 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