17-3 -- Stomach part 2 Flashcards
What are Hypertrophic Gastropathies?
Giant “cerebriform” enlargment of the rugal folds
Giant enlargement of the rugal folds?
Hypertrophic Gastropathies
What causes Hypertrophic Gastropathies?
Excessive growth factor release
= Epithelial hyperplasia without inflammation
What causes Hypertrophic Gastropathies?
Excessive growth factor release
= Epithelial hyperplasia without inflammation
Is inflammation present with Hypertrophic Gastropathies?
NO
2 types of Hypertrophic Gastropathies?
Menetrier Disease
Zollinger-Ellison Syndrome
= enlargement of rugal folds due to epithelial hyperplasia without inflmmation
2 types of Hypertrophic Gastropathies?
Menetrier Disease
Zollinger-Ellison Syndrome
Menetrier Disease involves excessive secretion of?
TGF-alpha
Menetrier Disease involves hyperplasia of what epithelial cells?
Mucous cells
What inflammatory cell infiltrate is seen with Menetrier Disease?
Lymphocytes
Symptoms and association for Menetrier Disease?
- Associated with Adenocarcinoma
= Hypoproteinemia, weight loss, diarrhea
Blood symptoms of Menetrier Disease?
Hypoproteinemia
Zollinger-Ellison Syndrome involves excessive secretion of?
Gastrin-secreting neuroendocrine tymors
Zollinger-Ellison Syndrome involves hyperplasia of what epithelial cells?
Parietal cells
What inflammatory cell infiltrate is seen with Zollinger-Ellison Syndrome?
Neutrophils
Symptoms of Zollinger-Ellison Syndrome?
Peptic ulcers
2 types of Gastric Polyps?
Inflammatory and Hyperplastic polyps
Fundic Gland polyps
2 types of Gastric Polyps?
Inflammatory and Hyperplastic Polyps
Fundic Gland Polyps
What causes Inflammatory and Hyperplastic Gastric Polyps?
H.pylori and Chronic Gastritis
What can Inflammatory and Hyperplastic Gastric Polyps cause?
Adenocarcinoma
What causes Fundic Gland Polyps?
Sporadic
FAP - mutations in APC gene
PPIs
What causes Fundic Gland Polyps?
Sporadic
FAP - mutations in APC gene
PPIs
Symptoms of Fundic Gland Polyps?
No symptoms or nausea
4 common malignancies of the stomach?
Adenocarcinoma
MALT lymphoma
Neuroendocrine/Carcinoid
GIST
4 common malignancies of the stomach?
Adenocarcinoma
MALT lymphoma
Neuroendocrine/Carcinoid
GIST
2 types of Gastric Adenocarcinomas?
Intestinal type
Diffuse type
Intestinal type gastric adenocarcinoma forms?
Bulky masses that are glandular
Bulky, glandular masses are seen with what gastric adenocarcinoma type?
Intestinal
Diffuse type gastric adenocarcinoma forms?
Thickened gastric wall
- presence of signet cells
Thickened gastric wall with signet cells is seen with what gastric adenocarcinoma type?
Diffuse
What mutations are present with Intestinal type adenocarcinoma?
Increased WNT signaling and Beta-catenin
Decreased APC gene
What mutation is present with Diffuse type adenocarcinoma?
Loss of E-cadherin
What locations of the stomach are usually affected with gastric adenocarcinomas?
Lesser curvature and antrum
What precursor lesions are commonly present with gastric adenocarcinomas?
Gastric dysplasia
Gastric adenoma
This stomach malignancy is most common in japan, chile, costa rica?
Gastric Adenocarcinomas
What metastases are common with Gastric Adenocarcinomas?
Virchow's node Irish node (axilla) Krukenberg tumor (bilateral ovaries)
What causes MALT lymphomas?
H.pylori and chronic gastritis
What can cure MALT lymphomas?
Eradicating H.pylori
What translocation and result of that are common with MALT lymphomas?
t(11:18)(q21:q21)
= (+) NF-KB ==> B cell growth and survival
What translocation and result of that are common with MALT lymphomas?
t(11;18)(q21:q21)
= (+) NF-KB ==> B cell growth and survival
MALT lymphomas have a dense ____ infiltrate
Lymphocytic infiltrate
MALT lymphomas have a dense lymphocytic infiltrate. What does that create?
Lymphoepithelial lesions
What markers will be (+) with MALT lymphomas?
CD19, CD20, CD43
- look similar to diffuse large b cell lymphomas
What symptoms are present with Neuroendocrine/Carcinoid neoplasms?
Flushing, sweating, bronchospasm
Right cardiac valvular fibrosis
A circumscribed yellow mass with salt and pepper chromatin is?
Neuroendocrine/Carcinoid neoplasm
What neoplasm (+) for synaptophysin, chromogranin and NSE?
Neuroendocrine/Carcinoid neoplasm
What 3 things do Neuroendocrine/Carcinoid neoplasms secrete?
Serotonin
Substance P
Polypeptide YY
Symptoms of Neuroendocrine/Carcinoid neoplasms?
Flushing, sweating, bronchospasm
Right cardiac valvular fibrosis
GIST
GI Stromal Tumor
What is the only mesenchymal GI tumor?
GIST
From what cells do GISTs arise?
Interstitial cells of Cajal
Interstitial cells of Cajal can give rise to?
GISTs
GISTs usually involve gain of function mutations in?
Receptor Tyrosine Kinase - KIT
PDGFRA
What should you treat GISTS with the usual mutations with?
Mutations in - KIT and PDGFRA
= Treat with Imatinib
Symptoms of GISTs?
Large masses, anemia, bleeding
- usually accidental discovery