A 50 yr. old male presents with obstructive symptoms. Biopsy of stomach reveals Gastrointestinal stromal tumor (GIST). Most appropriate marker for GIST is:
**Core Concept**
Gastrointestinal stromal tumor (GIST) is a type of tumor that arises from the interstitial cells of Cajal or their precursors, which are found in the gastrointestinal tract. These cells play a crucial role in regulating gut motility. GISTs are characterized by mutations in the KIT gene or the PDGFRA gene, leading to uncontrolled cell growth.
**Why the Correct Answer is Right**
The most appropriate marker for GIST is CD117 (c-Kit), which is a transmembrane receptor tyrosine kinase. The KIT protein is a product of the KIT gene, and mutations in this gene lead to the constitutive activation of the receptor, resulting in uncontrolled cell proliferation. CD117 is a specific marker for GIST and can be used for diagnostic purposes. Immunohistochemical staining for CD117 is a sensitive and specific method for identifying GIST cells.
**Why Each Wrong Option is Incorrect**
* **Option A:** CD34 is a marker that is often positive in GISTs, but it is not as specific as CD117. While CD34 can help in identifying GISTs, it is not the most appropriate marker.
* **Option B:** S-100 is a marker typically associated with neural crest-derived tumors, such as melanomas and schwannomas. It is not specific for GISTs.
* **Option D:** Vimentin is a general intermediate filament protein that is expressed in many types of tumors, including sarcomas. It is not specific for GISTs.
**Clinical Pearl / High-Yield Fact**
GISTs are often found in the stomach and small intestine, but they can occur in any part of the gastrointestinal tract. The diagnosis of GIST is primarily based on histopathological examination, and immunohistochemical staining for CD117 is a crucial diagnostic tool.
**Correct Answer:** C. CD117.