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Pathology > 8. GI Pathology - BP > Flashcards

8. GI Pathology - BP Flashcards

1
Q

What are the types of a gastric polyp?

A
  1. Hyperplastic (90%)
  2. Fundic gland (rare)
  3. Adenomatous (10%)
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2
Q

What is the epidemiology of intestinal type gastric adenocarcinoma?

A

Predominance in males; older than 50 years of age.

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3
Q

What is the mechanism of formation of intestinal type adenocarcinoma?

A

Tumors arise from a precursor lesion - intestinal metaplasia occuring in the background of chronic gastritis.

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4
Q

What are the main risk factors for intestinal-type gastric adenocarcinoma?

A
  1. Nitrites, smoked and salted food.
  2. Cigarette smoke
  3. Chronic gastritis with intestinal metaplasia
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5
Q

What is vital for staging intestinal-type gastric adenocarcinoma?

A

Depth of invasion into the wall of the stomach.

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6
Q

What is the gross morphology of intestinal-type gastric adenocarcinoma?

A
  1. Ulcer with heaped up margins.
  2. Polypoid projection.
  3. Flat or depressed.
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7
Q

What is the microscopic morphology of intestinal-type gastric adenocarcinoma?

A

Neoplastic and invasive intestinal-type epithelium

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8
Q

What is the epidemiology of diffuse (signet-ring cell) type gastric adenocarcinoma?

A

No male-female predominance; patients usually present younger than 50yrs of age.

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9
Q

What is the mechanism of formation of diffuse (signet-ring cell) type of gastric adenocarcinoma?

A

No precursor lesion; signet ring cell tumors do not arise from intestinal metaplasia.

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10
Q

What is the gross morphology of diffuse-type gastric adenocarcinoma?

A

Diffuse thickening of mucosa with no well-defined mass.

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11
Q

What is linitis plastica?

A

Thickening of the stomach wall.

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12
Q

What is the microscopic morphology of diffuse-type of gastric adenocarcinoma?

A

Signet-ring cells (eccentric nucleus with vacuole).

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13
Q

What are the three components used to categorize gastric carcinomas?

A
  1. Depth of invasion
  2. Microscopic appearance
  3. Histology
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14
Q

What is the Virchow node?

A

Metastasis of gastric carcinoma to supraclavicular node.

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15
Q

What is Sister Mary Joseph nodule?

A

Metastatic periumblical nodule.

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16
Q

What is the clinical presentation of gastric carcinoma?

A
  1. Abdominal discomfort
  2. Early satiety
  3. Nausea and vomiting
  4. GI hemorrhage
17
Q

What are the cells of origin of GI stromal tumors (sarcoma of the stomach)?

A

The intestitial cells of Cajal.

18
Q

What is the marker commonly associated with GI stromal tumor?

A

CD117+ (c-kit).

19
Q

What are the two main non neoplastic polyps of the GI?

A
  1. Hyperplastic polyps

2. Peutz-Jeghers polyps

20
Q

Give a basic description of hyperplastic polyps.

A

Common polyp of the large intestine, composed of hyperplastic colonic mucosa.

21
Q

Give a basic description of Peutz-Jeghers polyps.

A

Hamartomatous polyps, which include muscularis mucosa.

22
Q

What are the features of Peutz-Jeghers syndrome?

A
  1. Autosomal dominant
  2. Many GI polyps
  3. Increased pigmentation of the lips and oral mucosa.
  4. Patients have increased risk for developing pancreatic, breast, lung, and ovarian cancer.
23
Q

What are the main types of adenomas in the GI?

A
  1. Tubular
  2. Villous
  3. Tubulovillous
24
Q

What is the importance of an adenoma in the GI?

A

Can be precursor of malignancy. Villous > tubular.

25
Q

What is the epidemiology of colonic adenocarcinoma?

A

Older adults (>50).

26
Q

What is the pathogenesis of colonic adenocarcinoma?

A

Small polyps (adenomas) are dysplastic, and dysplasia can progress to neoplasia.

27
Q

Mention some risk factors for colonic adenocarcinoma.

A
  1. High fat, high refined carbohydrate diet.
  2. Familial adenomatous polyposis.
  3. Hereditary non polyposis colon cancer.
28
Q

What is the mutation associated with familial adenomatous polyposis?

A

APC gene in 5q21.

29
Q

What is the importance of familial adenomatous polyposis?

A

High risk for progression to invasive adenocarcinoma (100% of patients by age 50).

30
Q

Do we see increased numbers of polyps in hereditary non polyposis colon cancer?

A

No. (Compared to familial adenomatous polyposis)

31
Q

What colon adenocarcinomas present sooner?

A

Left-sided tumors by causing more of an obstruction.

32
Q

Is adenocarcinoma common in the small intestine?

A

No.

33
Q

What is the clinical presentation of colonic adenocarcinoma?

A

Right-sided lesions –> pain and change in stool caliber.

Left-sided lesions –> iron deficiency anemia due to hemorrhage.

34
Q

What do we suspect when we see iron deficiency anemia in patients over 50?

A

Colon cancer until proven otherwise.

35
Q

What is the usual location of a carcinoid tumor?

A
  1. Appendix
  2. Ileum
  3. Rectum
  4. Bronchi
36
Q

What is the target group of carcinoid tumors?

A

Older patients.

37
Q

What hormones can carcinoid tumors secrete?

A
  1. Gastrin (Zollinger-Ellison)
  2. Insulin
  3. Somatostatin
  4. Serotonin

Pathology (16 decks)

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