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GI > GI Malignancies > Flashcards

GI Malignancies Flashcards

1
Q

what type of disorders are assoc w/ dysphagia or solids, solids and liquids and oropharyngeal

A

Solid: mechanical disorders
Solids & liquids: motility disorders
Oropharyngeal: neuro disorders

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2
Q

what are the 2 main types of esophageal cancer & prevalance & where

A
  1. Squamous Cell Carcinoma - 90% - Asia, South & East Africa, Iran
  2. Adenocarcinoma - 5% - US & Western Europe
    MC in elderly, blacks and whites
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3
Q

what are risk factors for esophageal squamous cell carcinoma?

A

smoking & alcohol - biggest

prior hx of head/neck ca, lye ingestion, achalasia

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4
Q

what are risk factors for esophageal adenocarcinoma?

A

Barrett esophagus - MC

GERD, obesity, smoking, male, older age

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5
Q

what commonly seen in histo of esophageal squamous cell carcinoma?

A

tumor nests of keratinized pearls

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6
Q

what stain is used to test barrett esophagus?

A

Alcian blue/ PAS stain - stains metaplasic goblet cells blue

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7
Q

what parts of the world is gastric cancer MC seen?

A

Japan, Korea, Taiwan, Costa Rica, Ecuador, Peru, Brazil

4th MC cancer worldwide but rare in US b/c H pylori tx

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8
Q

what are risk factors for gastric cancer?

A

males, > 60 yo, asians/hispanics, H. pylori infection, smoking, diet high in smoked, salt cured and picked foods, obesity, inherited genetic syndromes

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9
Q

what are the 2 pathological types of gastric ca?

A
  1. intestinal - H pylori infection

2. diffused - gastric mucus cells w/ signet ring appearance

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10
Q

what are the 4 macroscopic growth patterns of gastric adenocarcinoma

A
  1. Exophytic
  2. Flat, depressed
  3. Excavated
  4. Extensive infiltration - linitis plastica
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11
Q

how can you treat early gastric cancer?

A

endoscopic mucosal resection (EMR), endoscopic mucosal dissection (ESD), esphagectomy

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12
Q

how can you treat gastric cancer that has spread to the mucos?

A

give chemo & radiation then do surgery

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13
Q

how can you treat gastric cancer that’s spread to lymph nodes (M1)

A

chemo or clinical trial

- high likelihood b/c lots of lymphatics close by

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14
Q

what’s gastrointestinal stroma tumor (GIST)?
what mutations are seen?
what stains can you see them w/

A

rare sarcoma malignancy but MC mesenchymal tumor of the abd, arises from interestitial cells of Cajal in wall of GI tract from mouth to anus but usually in stomach. Seen w/ spindle cells - DC117 or DOG-1 stain
mutations in KIT (MC - tyrosine-protein kinase, on exon 11) or PDGFRA

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15
Q

what 3 things control the rate of metastasis

A
  1. location
  2. tumor size
  3. rate of growth (mitosis/HPF)
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16
Q

how can you treat a GIST tumor?

A
  1. Tyrosine Kinase Inhibitors - Gleevac (Imatinib) or Sutent (Sunitinib)
  2. Surgery
17
Q

what’s the MC lymphoma of the GI tract?

A

MALToma - mucosal associated lymphoid tissue

18
Q

what’s MALToma?
what translocation can be assoc w/ it
Tx?

A

mucosal assoc lymphoid tumor - B cell malignancy in the marginal zone caused by chronic H pylori infection leading to translocations, most commonly t(11,18) bringing together apoptosis inhibitor 2 (API2) on chrom 11 w/ mutated MALT lymphoma MLT gene on chrom 18 - fuse promoting B cell prolif
Tx - can regress w/ antibiotics

19
Q

what types of cells are seen in histo of MALToma?

A

CD19/20 + B cells w/ lymphoepitheial lesions

20
Q

what are carcinoid tumors?

A

arise from neuroendocrine GI cells, produce peptide & non-peptide hormones

21
Q

what’s carcinoid syndrome?

where are these tumors usually primarily from

A

carcinoid tumor mets to liver releases serotonin into systemic circulation causing paroxysmal hot flashes, asthma-like wheezing, R sided HF
frequently from the midgut - ileum, jejunum

22
Q

describe what a carcinoid tumor would look like grossly

A

submucosal polypoid mass w/ overlying norm mucusoa

yellow-tan color

23
Q

what type of ca is anal canal carcinoma and what’s it often assoc w/?

A

squamous cell carcinoma often assoc w/ HPV infection

GI (8 decks)

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