Carcinoma of Stomach

20 cards   |   Total Attempts: 182
  

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Cards In This Set

Front Back
What is the most common type of gastric carcinoma
Adenocarcinoma
Where does adenocarcinoma occurs most frequently
Pre-pyloric region
What are the aetiology of gastric carcinoma?
H.pylori infections Dietary and EnvironmentalPre-malignant conditions and lesions
What are Dietary and Environmental risk factors?
- nitrosamine (from nitrite to nitrate) in smoked salmon and salted fish- low intake of fresh vegetables and fruits (antioxidants are protective)
What are the pre-malignant conditions and lesions?
Gastric adenomaChronic type A autoimmune gastritis Pernicious anaemia HP-related intestinal metaplasia & dysphasia in chronic atrophic gastritis
Macroscopic features of carcinoma of stomach (how do they look like)
- Ulcerative - Polypoid or fungating - Diffuse scirrhous (leather-bottle stomach or lintis plastic)
Microscopic features of carcinoma of stomach
- Intestinal --> formation of glandular structures- Diffuse--> malignant cells in sheets with minimal gland formation; diffuse infiltrative pattern; signet-ring cell
Signet ring cells
Cells with mucin distending cells and compressing the nucleus ==> looks like a ring
Spread of carcinoma of stomach
- 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)
Which is the most common way of spread of CA stomach
Lymphatics (to regional LN) - peri-gastric/ coeliac LN
Krunkenberg tumours
Bilateral ovarian solid tumours due to metastatic adenocarcinoma - gave rise by signet ring cell carcinoma
Early gastric cancer
A gastric carcinoma confined to mucosa +/- submucosa, regardless of the presence of lymph node metastasis (NOT the muscularis propria)
What is the difference in prognosis between gastric cancer and early gastric cancer
Early gastric cancer has excellent prognosis (even with LN metastasis) 95% 5-year survival rate after surgical resection
Difference between peptic ulcer and carcinoma of stomach (6 points)
Answer 14
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What should always be done to a gastric ulcer to differentiate between gastric ulcer and gastric malignancy?
Histological confirmation with endoscope examination and biopsy