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MD3002 > oesophageal and stomach cancer > Flashcards

oesophageal and stomach cancer Flashcards

1
Q

name some benign oesophageal tumours

A

– Mesenchymal Tumours
– Squamous papillomas

  • Leiomyomas
  • Fibromas
  • Lipomas
  • Haemangiomas
  • Neurofibromas
  • Lymphangiomas
  • Mucosal polyps
  • Squamous papillomas
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2
Q

name some benign stomach tumours

A

– Polyps
• Non-neoplastic
• Adenomas
– Mesenchymal

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3
Q

name some malignant oesophageal tumours

A

– Squamous Cell Carcinoma
– Adenocarcinoma

rarely: 
– Carcinoid tumour
– Malignant melanoma
– Lymphoma
– Sarcoma
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4
Q

name some malignant stomach tumours

A

– Carcinoma
– Lymphoma
– Carcinoid
– Mesenchymal

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5
Q

what is alchalasia

A

inability of circular smooth muscle to relax

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6
Q

what factors are associated with squamous cell carcinoma

A
  • Dietary
  • Deficiency of vitamins (A, C, riboflavin, thiamine, pyridoxine)
  • Fungal contamination of foodstuffs
  • High content of nitrites/nitrosamines
  • Lifestyle
  • Burning-hot beverages or food
  • Alcohol and tobacco
  • Oesophageal Disorders
  • Long-standing oesophagitis and Achalasia
  • Genetic Predisposition
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7
Q

what is the morphology of SSC

A 
– small, gray-white, plaque-like thickenings that
become tumourous masses
• Three patterns
• 1) protruded polypoid exophytic (60%),
• 2) flat, diffuse, infiltrative (15%),
• 3) excavated, ulcerated, (25%)
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8
Q

what is a pleomorphism

A

a variability in the size and shape of cells and their nuclei

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9
Q

what are the histological features of SSC

A

pleomorphism
hyperchromatism
mitotic figures
degree of dysplasia

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10
Q

what are the stigmata of SSC

A 
dysphagia
cachexia
haemorrhage and sepsis
TE fistula
metastasis
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11
Q

what can cause adenocarcinoma

A

Barrett’s oesophagus
intestinal metaplasia caused by gastric reflux
tobacco and obesity
found in the lower third of the oesophagus

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12
Q

what is the morphology of adenocarcinoma

A

flat or raised patches or nodular masses
may be infiltrative or ulcerative
mucin producing glandular tissue cancer

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13
Q

describe the T in TNM staging of carcinoma

A 
T0 is carcinoma in situ
T1 invasion of submucosa
T2 invasion of muscularis propria
T3 invasion of adventitia
T4 invasion of adjacent structures
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14
Q

describe N staging

A

N0 no node spread

N1 regional node metastases

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15
Q

describe M staging

A

M0 no distant spread

M1 distant metastases

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16
Q

describe the stigmata of adenocarcinoma

A
  • Dysphagia
  • Progressive weight loss
  • Bleeding
  • Chest pain
  • Vomiting
  • Heartburn
  • Regurgitation
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17
Q

what does sessile and pedunculated mean

A

sessile- no stalk

pedunculated- stalked

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18
Q

what is the most common type of stomach cancer

A

gastric carcinoma

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19
Q

What are the risk factors for gastric carcinoma

A 
• Infection by H. pylori
• Diet
• Low socioeconomic status
• Cigarette smoking
• Chronic gastritis
• Gastric adenomas
• Barrett oesophagus
 Slightly increased risk
with blood group A
 Family history
 Hereditary nonpolyposis
colon cancer syndrome
 Familial gastric
carcinoma syndrome
20
Q

where in the stomach are cancers most common

A

pylorus and antrum

21
Q

what type of growth patterns might be found

A

exophytic
flat/ depressed
excavated
linitis plastica

22
Q

what are the features of linitis plastica

A

‘leather bottle’
diffuse infiltrative gastric carcinoma
thickened gastric wall
mucosal erosion

23
Q

how might tumours be diagnosed

A

barium meal

24
Q

what are the two types of adenocarcinoma in Lauren classification

A

intestinal type

diffuse type

25
Q

describe intestinal type adenocarcinoma

A

neoplastic intestinal glands resembline colonic adenocarcinoma
cells often contain apical mucin vacuoles and abundant mucin

26
Q

describe diffuse type adenocarcinoma

A

composed of gastric-type mucous cells, which generally do not
form glands, but rather permeate the mucosa and wall as
scattered individual cells or small clusters in an “infiltrative”
growth pattern
• mucin formation expands the malignant cells and pushes the
nucleus to the periphery, creating a “signet ring”

27
Q

describe the spread of gastric carcinomas

A

All gastric carcinomas eventually penetrate
the wall and spread to regional and more
distant lymph nodes.
– Supraclavicular (Virchow) node
– Local invasion of gastric carcinoma into the
duodenum, pancreas, and retroperitoneum
– metastases to the liver and lungs are common

28
Q

what is Krukenburg tumour

A

stomach cancer metastases to the ovary

29
Q

describe N staging of gastric cancer

A

N0 - no LN metastasis
N1 - 1-6 lymph nodes
N2 - 7-15 lymph nodes
N3 - more than 15 lymph nodes

30
Q

what are the stigmata of gastric cancer

A
  • Asymptomatic until late
  • Weight loss
  • Abdominal pain
  • Anorexia
  • Vomiting
  • Altered bowel habits
  • Dysphagia
  • Anaemic symptoms
  • Haemorrhage
31
Q

what is gastric lymphoma

A

• B-cell lymphomas of mucosa-associated
lymphoid tissue (MALT lymphomas).
• >80% are associated with chronic gastritis and
H. pylori infection.
• PROGNOSIS: 50% five-year survival
commonly occurs in the mucosa or submucosa

32
Q

what is most common form of oesophageal cancer

A

SSC

33
Q

Where do oesophageal SSC most commonly occur

A

middle

34
Q

what kind of tumour is a small grey plaque like thickening

A

SSC

35
Q

What do SSCs most commonly look like

A

protruded polypoid exophytic

36
Q

what are the possible complications of an SSC

A

sepsis, fistula, haemorrhage, dysphagia

37
Q

what cancer does Barrets oesophagus become

A

adenocarcinoma

38
Q

what is the most common type of stomach cancer

A

gastric carcinoma

39
Q

what cells are found in the antrum

A

mucous cells and G cells

40
Q

what cells are found in the fundus

A

parietal cells and chief cells (pepsin)

41
Q

what cells are found in the cardia

A

mucous

42
Q

where do gastric carcinomas normally occur

A

pylorus and antrum

43
Q

what are gastric lymphomas normally caused by

A

H pylori and chronic gastritis

44
Q

what cancer does Barretts oesophagus lead to

A

adenocarcinoma

mucin producing glandular tumours

45
Q

what benign tumours of the stomach have malignant potential

A

adenomas

46
Q

what is the second most common tumour in the world

A

gastric carcinoma

47
Q

what cancer are you more at risk at if you have chronic gastritis or H. pylori infection

A

gastric lymphoma

MD3002 (56 decks)

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