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Related Flashcards
Cards In This Set
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What is the most common type of gastric carcinoma
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Adenocarcinoma
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Where does adenocarcinoma occurs most frequently
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Pre-pyloric region
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What are the aetiology of gastric carcinoma?
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H.pylori infections Dietary and EnvironmentalPre-malignant conditions and lesions
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What are Dietary and Environmental risk factors?
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- nitrosamine (from nitrite to nitrate) in smoked salmon and salted fish- low intake of fresh vegetables and fruits (antioxidants are protective)
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What are the pre-malignant conditions and lesions?
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Gastric adenomaChronic type A autoimmune gastritis Pernicious anaemia HP-related intestinal metaplasia & dysphasia in chronic atrophic gastritis
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Macroscopic features of carcinoma of stomach (how do they look like)
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- Ulcerative - Polypoid or fungating - Diffuse scirrhous (leather-bottle stomach or lintis plastic)
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Microscopic features of carcinoma of stomach
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- Intestinal --> formation of glandular structures- Diffuse--> malignant cells in sheets with minimal gland formation; diffuse infiltrative pattern; signet-ring cell
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Signet ring cells
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Cells with mucin distending cells and compressing the nucleus ==> looks like a ring
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Spread of carcinoma of stomach
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- direct spread: to adjacent organs (liver, duodenum) - lymphatic spread: to regional lymph nodes (coeliac LN/ L supraclavicular LN) - Hematogenous: through blood (liver: portal vein, brain, lungs, bone marrow)- Transcelomic spread: through peritoneum (seedling of tumour) (e.g. ovaries)
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Which is the most common way of spread of CA stomach
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Lymphatics (to regional LN) - peri-gastric/ coeliac LN
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Krunkenberg tumours
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Bilateral ovarian solid tumours due to metastatic adenocarcinoma - gave rise by signet ring cell carcinoma
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Early gastric cancer
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A gastric carcinoma confined to mucosa +/- submucosa, regardless of the presence of lymph node metastasis (NOT the muscularis propria)
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What is the difference in prognosis between gastric cancer and early gastric cancer
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Early gastric cancer has excellent prognosis (even with LN metastasis) 95% 5-year survival rate after surgical resection
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Difference between peptic ulcer and carcinoma of stomach (6 points)
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 - |
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What should always be done to a gastric ulcer to differentiate between gastric ulcer and gastric malignancy?
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Histological confirmation with endoscope examination and biopsy
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