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GI: stomach > Gastric Tumours > Flashcards

Gastric Tumours Flashcards

1
Q

what are the benign gastric tumours? 2

A

hyperplastic polyps

cystic fundic gland polyps

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2
Q

what are the malignant tumours of the stomach? 3

A

carcinomas (most are adenocarcinomas unsurprisingly)

lymphomas

gastrointestinal stromal tumours (GIST) - distinct group of mesenchymal tumours

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3
Q

In the UK proximal adenocarcinoma tumours of the cardia/GOJ are ____ and distal tumours are _____

A

In the UK proximal tumours of the cardia/GOJ are increasing and distal tumours are decreasing

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4
Q

what are the two major histological types of adenocarcinoma?

A

intestinal and diffuse

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5
Q

intestinal : ____ /____ mass

diffuse: ___ /____ stomach wall

A

Intestinal : exophytic/polypoid mass- this is more resectable. These are well formed glandular structures

Diffuse: expands/infiltrates stomach wall

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6
Q

benign peptic ulcers ___ adenocarcinoma but they are more ___ __ and lack a ___ ___ ___

A

mimic, punched out and lack a raised rolled edge

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7
Q

what is the aetiology of adenocarcinoma? 5

A

H Pylori infection important

other premalignant conditions

  • pernicious anaemia
  • partial gastrectomy
  • HNPCC/lynch syndrome
  • menetrier’s disease
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8
Q

how do adenocarcinomas spread? 3

A

local spread into other organs

lymph nodes

haematogenous

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9
Q

what is an important site for local invasion?

A

ovaries - kruckenburg syndrome

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10
Q

what is the node that is a sign of gastric cancer?

A

virchows node - left clavicular

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11
Q

why is early liver metastases common?

A

the venous drainage from the stomach is straight to the liver

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12
Q

what is gastric lymphoma derived from?

A

the mucosa associated lymphoid tissue

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13
Q

lymphoma is associated with _____ infection

A

H.Pylori

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14
Q

lymphoma involves continuous ______ which induces an evolution into a ___ ___ cell- proliferation - this is a __ grade lymphoma
If left unchecked it evolves into a ___ grade lymphoma

A

It involves continuous inflammation which induces an evolution into a clonal B cell- proliferation - this is a low grade lymphoma
If left unchecked it evolves into a high grade lymphoma

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15
Q

where is the commonest site for lymphoma in the GI tract and why?

A

The stomach is the commonest site for lymphoma in the GI tract because of the large amount of lymphoid tissue

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16
Q

what does lymphoma look like histologically ?

A

small round lymphoid cells

17
Q

most people that have lymphoma will be ______

A

asymptomatic

18
Q

what are the signs of gastric cancer?

A
  • Abdominal mass
  • Jaundice
  • Paraneoplastic syndrome
  • Weight loss
19
Q

what are the symptoms?

A

dyspepsia - abdominal pain, emesis, anorexia, dysphagia, early satiety

upper GI haemorrhage

20
Q

what is picked up on physical examination?

A

weight loss, lymph nodes - large virchow’s, abdominal masses

21
Q

how is it diagnosed?

A

upper GI endoscopy and biopsy

22
Q

what imaging techniques are done

A

barium meal

  • CT (MRI) scan
23
Q

what are the treatment options?

A

surgery

radiotherapy

chemotherapy

24
Q

surgery

A

For palliation of symptoms and for improved survival
Abdominal operation
Can remove involved adjacent organs

25
Q

what are the contraindications of surgery? 3

A
  • Widely metastatic disease
  • Malignant ascites
  • Brief life expectancy
26
Q

surgery

  • ____- gastrectomy for proximal lesions
  • ___ gastrectomy for distal lesions
A

Total gastrectomy for proximal lesions

Partial gastrectomy for distal lesions

27
Q

when is chemotherapy done?

A

in advanced and metastatic disease

28
Q

what are the adverse prognostic factors for gastric cancer? 6

A
  • Metastatic disease
  • Short history
  • Advanced age
  • Proximal lesion
  • Locally advanced lesion
  • Superficial gross appearance

GI: stomach (3 decks)

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