Gastrointestinal autonomic nerve tumors: Immunohistochemical and ultrastructural studies in cases of gastrointestinal stromal tumor

The gastrointestinal autonomic nerve tumor (GAN tumor) is an uncommon stromal tumor with a morphological feature resembling the cell processes of the enteric plexus, and was originally termed a plexoma or plexosarcoma. Light microscopic studies show the GAN tumor most often consists of spindle-shaped cells indistinguishable from a smooth muscle tumor or Schwann cell tumor. Immunohistochemical and ultrastructural examinations of 18 cases of gastrointestinal stromal tumor (GIST) were performed. During ultrastructural examination, all of the 12 cases which were immunohistochemically positive for S-100 protein or neuron-specific enolase (NSE) showed synapse-like structures containing dense core neurosecretory granules measuring 100-200 nm, and 40-60 nm endocytoplasmic vesicles. These results suggest that most GIST of neurogenic origin are tumors derived from the myenteric nerve plexus.