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NM By Myself > GIT Cancer NM > Flashcards

GIT Cancer NM Flashcards

1
Q

Esophageal cancer stage II

A

IIA - lower 1/3 T3
IIB - upper 2/3 T3

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2
Q

Esophageal cancer unresectable

A

Aorta, vertebral body, trachea, bronchi, lung

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3
Q

Esophageal cancer stage III

A

N1

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4
Q

Esophageal cancer M

A

Liver
Lung
Bone

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5
Q

Smoking + alco
Esophagus

A

SCC, middle 1/3

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6
Q

Obesity, reflux

A

Adenocarcinoma, distal, GEJ within proximal 5 cm

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7
Q

Esophageal cancer diagnosis

A

EUS - most sensitive for tumor depth
FDG - more sensitive than CT in LN

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8
Q

Esophageal cancer FDG indication

A

Distant MTS
LN involvement
Response to neoadj treatment
Local recurrence - - dd fibrosis vs edema
False negative - - small T1-2, necrotic, mucinous
3-4 weeks after chemoradio
6 weeks after surgery

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9
Q

FDG T staging esophageal cancer

A

T1-2 - asymmetric thickening
T3 - wall thickening >5 mm or mass causing luminal obstruction

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10
Q

Esophageal cancer LN

A

> 1 cm in short axis or >5 mm supraclavicular
Upper esophagus - cervical and mediastinal
Lower esophagus - abdominal

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11
Q

Esophageal cancer treatment

A

Chemo radio + surgery

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12
Q

T3 dd esophageal vs gastric

A

Esophageal - no serosa - - adventitia - - easy to spread
Gastric - subserosa - serosa

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13
Q

Gastric T4

A

Not duodenum or esophagus

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14
Q

Gastric cancer LN

A

Sister Mary Joseph’s LN - Periumbilical
Celiac >6 mm
Perigastric >8 mm
Clustering >3 LN
Risk for LN:
T4, tumor >2 cm, ulcer, mucinous

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15
Q

Gastric cancer M

A

Liver
Peritoneum - - Krukenberg
Lung
Bone

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16
Q

Gastric cancer type

A

Adenocarcinoma 90%
Intestinal type - older, distal, pernicious anemia
Diffuse type (signet ring cell) - <50 y, cardia, linitis plastica (diffuse thickening), reflux, obesity, ILC breast ca

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17
Q

Gastric cancer risk

A

H. Pylori, alco, salt, meat - - distal, antral
Obesity, dysphagia - - proximal, cardia
Reflux - - GEJ
Vomit - - pylorus
Menetrier disease (giant hypertrophic gastritis)
Peutz-Jeghers syndrome
Smoking

18
Q

Gastric cancer staging

A

EUS - local invasion
CT thorax+abdomen+pelvis - - wall thickening >5 mm, advanced T, LN
FDG detection rate of primary tumor 55% - - no role in T staging, higher accuracy in LN, not sensitive for detecting peritoneal involvement

19
Q

Gastric cancer low FDG uptake

A

Mucinous, signet ring cell, poorly diff

20
Q

Gastric cancer treatment

A

Surgery + post-op chemo radio

21
Q

RT hemicolectomy if appendix cancer

A

Involvement of colon or base of appendix
Periappendicular area
Tumor size >2 cm
High grade
LN
Invades through muscularis propria
Colonic-type adenocarcinoma

22
Q

Colon cancer type

A

Right - anemia, occult blood, polypoid
Left - bleeding, altered bowel habits, pain, obstruction
Distal - circumferential, apple core
Adenocarcinoma 90%
Mucinous - - peritoneal spread - - Krukenberg
Ascending/descending - - retroperitoneum
Rectosigmoid - - worse prognosis

23
Q

Premalignant colon polyp

A

Tubular
Tubulovillous
Villous
Sessile
Pedunculated
Depressed

24
Q

Anal carcinoma T

A
25
Q

Anal cancer N

A

Proximal - - perirectal along IMA
Below dentate line - - inguinal, external iliac
Above dentate line - - mesorectal, internal iliac

26
Q

Colon cancer FDG

A

Focal uptake malignant
No diff radio necrosis vs recurrence
At least 4 weeks after radio
Any incidental focal Colonic uptake - - colonoscopy
Mucinous - - calcification in liver MTS dd after chemo
Response to chemo radio not superior than CT, except for rectal cancer

27
Q

Anal cancer FDG

A

98% avid
Big role for staging
Not for treatment response: min residual activity 1 month follow up

28
Q

Colon cancer M

A

Liver (portal vein) - - resection
Lung (recto sigmoid through paravertebral venous)
Bone
Brain

29
Q

Colon cancer diagnosis

A

Colonoscopy
CT
MRI

30
Q

Anal cancer risk

A

HPV - - SCC
Female > male

31
Q

Anal cancer imaging

A

Pelvic MRI not T1 or endo anal US
FDG - LN staging, 20% change in staging
FDG benefit - detect residual subclinical pelvic or extra pelvic /para aortic node involvement

32
Q

Anal cancer type

A

<2 cm above dentate line - - anal ca
>2 cm above dentate line - - rectal ca
Skin within 5 cm of anus - - perianal ca
SCC 90% better prognosis
Adenocarcinoma, melanoma, small cell carcinoma

33
Q
A

Liver MTS from colon cancer

34
Q
A

Recurrence of colorectal cancer in liver

35
Q

GIST T

A
36
Q

GIST M

A

Liver
Peritoneum
Retroperitoneum
Lung

37
Q

Carney triad

A

GIST
Pulmonary chondroma
Extraadrenal paraganglioma

38
Q

GIST risk

A

Neurofibromatosis type 1 - - small bowel
Anemia
Pulpable mass, obstruction
Exophytic growth, 2-30 cm
Treatment - glivec

39
Q

GIST PET

A

Response grade based on changes in SUV

40
Q
A

GIST small bowel

NM By Myself (25 decks)

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