GI Neoplasia I Flashcards
What are factors associated with squamous cell carcinoma?
alcohol, smoking, urban and lower SEC pop, dietary and environmental factors that cause chronic esophageal irritation, hpv, achalasia, high red meat consumption
What are risk factors associated with adenocarcinoma of esophagus?
barrett’s esophagus
GERD
Truncal obesity
What is the stereotypical squamous esophageal cancer patient?
60-70 black male smoking alcoholic in the midesophagus
What the steroetypical pt with adenocarcinoma of esophagus
white male with barrett’s esophagus in 50s or 60s in the distal esophagus
What are symptoms of esophageal carcinoma?
dysphagia, weight loss, odynophagia, aspiration anemia
largely due to narrowing or olceration of esophagus
when do you see hyperplastic gastric polyps?
chronic inflammation, h pylori, atrophic gastritis, usually asx (75% of gastric polyps)
What are fundic gland gastric polyps associated with?
PPI use or FAP
What are adenomatous gastric polyps?
10% of gastric polyps
most are in antrum associated with atrophic gastritis
may be sessile or pendunculated
precursor lesion of some cancers
What is the epidemiology of gastric cancer?
lower sec and in developing countries, males more than females, 70s
what are risk factors for gastic cancers?
chronic atrophic gastritis pernicious anemia prior gastric surgery high dietary nitrates adenomatous gastric polyps h pylori infxn (increases risk 3-6 times)
What are the two most common types of gastric neoplasia?
adenocarcinoma and lymphoma
What are symptoms of gastric cancer?
early perineural invasion - pain
diaphragmatic invasion leading to hiccoughs
Infiltration - decreased compliance and early satiety with weight loss
What are additional symptoms of gastric cancer in order of frequency?
weight loss, abd pain, nausea, dysphagia, melena, early satiety, ulcer-type pain
What are two common physical findings in gastric cancer?
virchow’s node - left supraclavicular node
sister mary joseph node - periumbilical nodule
What is linitis plastica?
an aggressive diffused gastric cancer that infiltrates the gastric wall with a rigid thickened stomach
what is the waterbottle stoamch associated with?
linitis plastica
What type of gastric cancer doesn’t require surgery?
lymphoma
What mutuation is present in sqcca of esophagus?
Not present
p53 is commonly present
KRAS and APC gene are not present in sqcca of esophagus
What are the gross appearance of sqcca of esophagus?
small gray-white plaque-like thickenings
become protruding flat or excavated
What is the molecular pathogenesis of esophageal adenocarcinoma? important question
early: p53 mutation or overexpression in barrett’s
allelic loss of silencing by hypermethylation of p16/ink4 cyclin-dependent kinase inhibitor
amplification of HER2 (cERBB2), cyclin D1 or cyclin E
Are cellular bridges present in progressed barrett’s esophagus?
yes
Why is it hard to determine that esophageal cancer was adenocarcinoma from barrett’s as opposed to mets?
Barrett’s causes intestinal epi. So once goblet cells decrease (with increasing malignancy), less signs that it was stoamch-induced metaplasia initially.
On histo, what do you see with hyperplastic gastric polyp?
hyperplastic mucosal epi
inflamed edematous stroma
What are the two types of gastric carcinoma?
intestinal type and diffuse type
