GI cancer Flashcards
Describe the most common benign and malignant tumors of the esophagus including causes, associations, pathogenesis and appearances Describe the most common benign and malignant tumors of the stomach including causes, associations, pathogenesis and appearances Describe the role H. pylori infection plays in carcinogenesis Describe the most common benign and malignant tumors of the small bowel including causes, associations, pathogenesis and appearances Describe the most common benign and mal
benign tumor of esophageal smooth muscle
leiomyoma
most common malignant neoplasm type worldwide
esophageal SSC
ethicity risk of esophageal SSC
blacks much more than whites
causes most cases of US esophageal SCC
EtOH and smoking
base pathologic cause of esophageal SCC
chronic esophagitis
intercellular bridges, prominent nuclei and kertinization suggest
SCC
most common site of esophageal SCC
middle 1/3 of esophagus
reason esophageal SCCs spread so rapidly
rich lymphatics in the submucosa promote extensive curcumferental and longitudinal spread
where adenocarcinoma of esophagus arises
distal esophagus
most common esophageal cancer in caucasians
adenocarcinoma
precursor to adencarcinoma of the esophagus
barrett’s esophagus
key step in development of esophageal adenocarcinoma
dysplasia (NOT METAPLASIA)
dysphagia with weight loss, bleeding, chest pain and vomiting after long term GERD
adenocarcinoma of esophagus
most common stomach cancer type
gastric carcinoma
main histological subgroups of gastric cancer
intestinal
diffuse infiltrative
gastric cancer most likely in older man
intestinal
gastric cancer in youger male or female
diffuse-infiltrative
risk factors involved in which stomach cancer
intestinal
risk factors in gastric cancer (intestinal type)
h pylori
high nitrate, salt, cured meat diet
low green leafy veg and citrus fruit
gastric carcinoma with precorsor lesions
intestinal
distended mucin “signet ring” cells
infiltrative gastric carcinoma
most common part of stomach in gastric carcinoma
pylorus and antrim
ulcer with rolled/heaped edges
gastric adenocarcinoma
“water bottle” stomach
invasive type gastric carcinoma
most important progostic determinant of gastric carcinoma
depth of invasion
weight loss, abdominal pain, anorexia, vomiting, altered bowel habits
gastric carcinoma
sentinal sign of gastric cancer
virchow (supraclavicular) node
sign that gastric cancer may have returned
sister mary joseph node (subcutaneous periumbilicle nodule)
gastric met to ovaries called
krukenberg tumor
most common malignant tumor of small bowel
duodenal adenocarcinoma
before this age, a colon cancer should be considered possible a UC or polyposis syndrome
50
dietary risk factors for colon cancer
high fat/low fiber
less A,C,E vitamins
anemia with weakness and fatigue
right colon cancer
occult bleeding, changes in bowek habits, crampy abdominal discomfort
left colon cancer
worse location t get colon cancer
left
grow as exophytic masses
right colon cancer
does not commonly obstruct
right colon cancer
greater microsatellite instability
right colon cancer
annular encirculing lesions with ulcerated midsection
left colon cancer
most important prognostic indicator of colon cancer
extent of tumor at diagnosis
two colo-rectal cancer molecular pathways
APC/Beta catenin
microsattellite instability pathway
transcription factor in nucleus that regulates proliferation/apoptosis
B catenin
80% of colon cancers have inactivated
APC
most freqently activated oncogene in colon cancer
K-RAS
common in colon cancer but infrequent in ademomas
loss of p53
high telomerase activity
germ-line mutation of cancer supression gene
APC
protooncogene mutation
K-RAS
loss of additonal cancer supresor gene in adenoma
p53
telemorase found in
carcinoma
defective DNA repair casued by inactivation of DNA mismatch repair genes
microsatellite instability
causes HNPCC syndrome
microsatellite instability
colon cancer pathway with better prognosis
microsatellite instability
most common site of carcinoid tumor
appendix
secretion of many different active bioactive hormones
carcinoid syndrome
yellow or tan tumors arising just below the mucosa
carcinoid tumors
salt and peper nuclei
carcinoid tumor
50% will go away if h pylori is removed
gastric MALT timor
