6 - Stomach Path Flashcards
parietal and chief cell histology and secretions
parietal - pink, acid
chief - purple, pepsinogen
which cells in stomach secrete mucin?
foveolar cells
pathogenesis of gastritis
depleted mucous layer protecting mucosa (natural dec in elderly, NSAIDs dec PGs)
inc stomach acidity (hypersecretion, acid ingestion)
dec blood supply (not enough supply of bicarb,etc)
how often is gastric mucosa replaced?
2-6d
sx of acute gastritis
epigastric pain, nausea, vomiting
can result in more severe things like erosions, ulcers, hemorrhage, massive blood loss
path findings in active gastritis
enhanced lymphoid follicles
WBCs infiltrating epithelial cells
MCC chronic gastritis
H pylori
which part of stomach does H pylori primarily affect?
antrum
how does h pylori lead to gastric adenoCA?
chronic gastritis > loss of parietal cell mass / oxyntic atrophy > intestinal metaplasia > inc CA risk (goblet cells in stomach)
MC malignancy of stomach
adenoCA
early and late sx of gastric adenoCA
early - dyspepsia, dysphaga, nausea
late - wt loss, anorexia, altered bowel habits, anemia, hemorrhage
gastric adenoCA epi
2/3 men
more common in lower SES
H pylori, GERD, obesity risk factors
gastric adenoCA assoc mutations/conditions
familial adenomatous polyposis
sporadic cases - beta catenin mutation, hypermethylation of growth factor genes, p53 mutations**
gross path of gastric adenoCA
MC in antrum, lesser curvature > greater curvature
bulky tumor for intestinal type
diffuse type gastric cancer
uniform prevalence across countries (unlike intestinal), male = female
gastric adenoCA signet ring cell type is also called
poorly differentiated
prognosis for gastric CA
early stage - very good >90% after 5 yrs
advanced - very bad <20% after 5 yrs
GI stromal tumors have what kind of cells?
spindle cells
MC mesenchymal tumor of abdomen
GI stromal tumor
GI stromal tumors arise from
interstitial cells of Cajal
GI stromal tumor that is resposive to gleevec
exon 11 mutation
most common gene mutated in GI stromal tumors
c-KIT
