Gastric Tumours/Cancers Flashcards
What are risk factors for gastric tumour/cancers?
Age Male H. pylori Poort diet Smoking FHx
The majority of gastric tumours/cancers are caused by?
H. pylori
What are examples of benign gastric tumours?
Hyperplastic polyps
Cystic fundi gland polyps
What are examples of malignant gastric tumours?
Carcinomas
Lmphomas
GISTs
What are GISTs?
Gastro-intestinatal stromal tumours
How can gastric adenomas become malignant?
H. pylori - chronic gastritis - atrophy - intestinal metaplasia - dysplasia - neoplasia
What are examples, besides gastric adenomas, of premalignant conditions?
Pernicious anaemia
Partial gastrectomy
HNPCC or Lynch syndrome
Méneiér’s Disease
What are subtypes of gastric adenomas?
Intestinal
Diffuse
What are features of intestinal gastric adenomas?
Tends to produce exophytic polypoid mass
What are features of diffuse gastric adenomas?
Expands
Infiltrates stomach wall
What are the subtypes of diffuse gastric adenomas?
Linitis plastica
Signet right type
What is characteristic features of linitis plastica?
every layer of stomach is invaded
How do gastric adenomas spread?
Local (other organs, peritoneal cavity, ovaries)
Lymph nodes
Haematogenous (to liver)
What is the name of a gastric adenoma that spreads to the ovaries?
Krudenberg tumour
What is a gastric MALT lymphoma?
Derived from mucosa-associated lymphoid tissue (MALT) and is associated with H. pylori infection
What is the pathophysiology of Gastric MALT Lymphoma?
Continuous inflammation induces clonal B cell proliferation = low grade lymphoma
If untreated –> high-grade B-cell lymphoma
How do you treat Gastric MALT Lymphoma?
PPI + Antibiotics to eradicate H. pylori (may stop cancer if early enough)
How do gastric tumours/cancers present?
Non-specific
Late signs: indigestion, fatigue, bloating, abode pain, weight loss, vomiting, dysphagia, anaemia
When do you refer?
Acute GI bleeding Dyspepsia + chronic GI bleed Progressive dysphagia Progressive unintentional weight loss Persistent vomiting Epigastric mass
What are signs/symptoms specific to MALT Lymphoma?
Dyspepsia Epigastric discomfort Gastric bleeding Fatigue Low grade fevers Nausea Constipation Weight loss Anaemia Recurrent RTIs
How do investigate gastric tumours/cancers?
Endoscopy
FBC, LFTs, U+Es, LFTs, Endoscopy, Biopsy (WCC will be off)
How do you treat gastric cancer/tumours?
Surgery
Nutritional support
Symptom control
What are the theories behind how H. Pylori stops gastric acid secretion?
Direct effect of bacterial products /ammonia, Cave’s factor / a-methyl histamine)
Effect of body inflammation induced by H.P; IL 1B - increase gastritis = powerful acid secretion inhibitor?
