Common Gi Malagnancies

Question 1

What are some of the clincal features of a oesphageal carcinoma?

Answer 1

Progressively worsening dyphagia and weight loss

Question 2

What are some of the investigations in a osephageal carcinoma?

Answer 2

Endoscopy, biposy, barium

Question 3

What are the different pathoglogies of an osephageal carcinoma?

Answer 3

Sqaumous cell carcinoma which is the commenest, and in any area of the oesphagus, and then adenocarcinoma which is uncommon, in the lower third and associated with barrets osephagus

Question 4

How does adenocarcinoma of the ospehagus develop?

Answer 4

From the metaplasic epithelium of barrets osephagus, where it progresses through dyplasia

Question 5

What are some of the clincal features of a gastric carcinoma?

Answer 5

Symptoms are often vague but include epigastric pain, vomiting and weight loss

Question 6

What are some of the macrospcopic features of a gastric carcinoma?

Answer 6

Fungating ulcerating, inflitrative and early

Question 7

What are some of the mircoscopic appearances of a gastric carcinoma?

Answer 7

Intestinal has a variable degree of gland fromation, whereas difssue and single cells and small groups and the appearnace of singet ring cells

Question 8

What are some of the ways that a gastric cancer can spread?

Answer 8

Direct, lymph nodes, liver and transcolemic

Question 9

Why are helicobacter pylori and gastric cancer associated?

Answer 9

As there is a general association of chronic inflmation and cancer,

Question 10

What are some of the features of a gastric lymphoma>

Answer 10

Starts as a low grade lesion and has a strong assoication with helicobacter pylori., and eradication of this may actually lead to the regression of the tumour

Question 11

What are some of the macroscopic deatures of adenomas of the large intestine?

Answer 11

They can either be sessile (immobile without a stalk) or peduncutate (does not have a stalk)

Question 12

What is familial adenomatous polypotsis and which gastric cancer is it associated with?

Answer 12

It is an autosomal dominant genetic condition that is associated with chormosome 50, and there are thoughs of gastric adenomas by the age of 20 one of which is likley to develop into a gastric adenocaricnoma

Question 13

What are some of the macroscopic features of a colorectal adenocarcinoma?

Answer 13

60-70% is rectosigmoid, and have fungating and stenotic features, and has unpreditable behouviou that includes pleomorphism, necrosis and mitoses

Question 14

What are some of the causes of a colorectal adenocarcinoma?

Answer 14

Low residue diet, a genetic predispostion, high fat intake and slow movement of food

Question 15

What are some of the mircopscopic features of colorectal adenocarcinoma?

Answer 15

There are singet ring ytpe cells and mucin

Question 16

What are some of the genetic causes of colorectal adenocarcinoma?

Answer 16

FAP, ras mutations, K_ras, N-Ras, B-raf, 18q, 17p

Question 17

How does a colorectal adenomcarinoma spread?

Answer 17

Direct through the bowel wall towards the adajcent organs, and via the lymphatics to the mesentric lymph nodes

Question 18

What are some of the features of the dukes staging of cancer?

Answer 18

A- confined to the bowel wall
B-through the wall but the lymph nodes are clear
C- lymph nodes are invaded
C1/2 - whether the highest nodes are clear

Question 19

What are some of the early syptoms of cancer of the pancreas?

Answer 19

Jaundice, as it can block the common bile duct, trosseaus sign, wieth loss

Question 20

What are some of the features of the histology of the caricnomas of the pancreas?

Answer 20

80% are ductal adenocarcinoms, well formed glands, and tumours may contain zymogen granules

Question 21

What is a zollinger ellsion tumout?

Answer 21

Is a gastrinoma, and secretes a large amount of gastrin that affects the prodcuction of acid in the stomach

Question 22

What is a VIPOMA?

Answer 22

Affects the B-islet cells of the pancreas

Question 23

What are some of the beign tumours of the liver that you may see?

Answer 23

Hepatic adenoma, hemiogoma, bile duct adenoma

Question 24

What are some of the maligant tumours of the liver that you may see?

Answer 24

Hepatocellular carcinoma, hepatoblastoma, cholingenic