oesophageal and stomach cancer Flashcards
name some benign oesophageal tumours
– Mesenchymal Tumours
– Squamous papillomas
- Leiomyomas
- Fibromas
- Lipomas
- Haemangiomas
- Neurofibromas
- Lymphangiomas
- Mucosal polyps
- Squamous papillomas
name some benign stomach tumours
– Polyps
• Non-neoplastic
• Adenomas
– Mesenchymal
name some malignant oesophageal tumours
– Squamous Cell Carcinoma
– Adenocarcinoma
rarely: – Carcinoid tumour – Malignant melanoma – Lymphoma – Sarcoma
name some malignant stomach tumours
– Carcinoma
– Lymphoma
– Carcinoid
– Mesenchymal
what is alchalasia
inability of circular smooth muscle to relax
what factors are associated with squamous cell carcinoma
- 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
what is the morphology of SSC
– 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%)
what is a pleomorphism
a variability in the size and shape of cells and their nuclei
what are the histological features of SSC
pleomorphism
hyperchromatism
mitotic figures
degree of dysplasia
what are the stigmata of SSC
dysphagia cachexia haemorrhage and sepsis TE fistula metastasis
what can cause adenocarcinoma
Barrett’s oesophagus
intestinal metaplasia caused by gastric reflux
tobacco and obesity
found in the lower third of the oesophagus
what is the morphology of adenocarcinoma
flat or raised patches or nodular masses
may be infiltrative or ulcerative
mucin producing glandular tissue cancer
describe the T in TNM staging of carcinoma
T0 is carcinoma in situ T1 invasion of submucosa T2 invasion of muscularis propria T3 invasion of adventitia T4 invasion of adjacent structures
describe N staging
N0 no node spread
N1 regional node metastases
describe M staging
M0 no distant spread
M1 distant metastases
describe the stigmata of adenocarcinoma
- Dysphagia
- Progressive weight loss
- Bleeding
- Chest pain
- Vomiting
- Heartburn
- Regurgitation
what does sessile and pedunculated mean
sessile- no stalk
pedunculated- stalked
what is the most common type of stomach cancer
gastric carcinoma
What are the risk factors for gastric carcinoma
• 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
where in the stomach are cancers most common
pylorus and antrum
what type of growth patterns might be found
exophytic
flat/ depressed
excavated
linitis plastica
what are the features of linitis plastica
‘leather bottle’
diffuse infiltrative gastric carcinoma
thickened gastric wall
mucosal erosion
how might tumours be diagnosed
barium meal
what are the two types of adenocarcinoma in Lauren classification
intestinal type
diffuse type
describe intestinal type adenocarcinoma
neoplastic intestinal glands resembline colonic adenocarcinoma
cells often contain apical mucin vacuoles and abundant mucin
describe diffuse type adenocarcinoma
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”
describe the spread of gastric carcinomas
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
what is Krukenburg tumour
stomach cancer metastases to the ovary
describe N staging of gastric cancer
N0 - no LN metastasis
N1 - 1-6 lymph nodes
N2 - 7-15 lymph nodes
N3 - more than 15 lymph nodes
what are the stigmata of gastric cancer
- Asymptomatic until late
- Weight loss
- Abdominal pain
- Anorexia
- Vomiting
- Altered bowel habits
- Dysphagia
- Anaemic symptoms
- Haemorrhage
what is gastric lymphoma
• 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
what is most common form of oesophageal cancer
SSC
Where do oesophageal SSC most commonly occur
middle
what kind of tumour is a small grey plaque like thickening
SSC
What do SSCs most commonly look like
protruded polypoid exophytic
what are the possible complications of an SSC
sepsis, fistula, haemorrhage, dysphagia
what cancer does Barrets oesophagus become
adenocarcinoma
what is the most common type of stomach cancer
gastric carcinoma
what cells are found in the antrum
mucous cells and G cells
what cells are found in the fundus
parietal cells and chief cells (pepsin)
what cells are found in the cardia
mucous
where do gastric carcinomas normally occur
pylorus and antrum
what are gastric lymphomas normally caused by
H pylori and chronic gastritis
what cancer does Barretts oesophagus lead to
adenocarcinoma
mucin producing glandular tumours
what benign tumours of the stomach have malignant potential
adenomas
what is the second most common tumour in the world
gastric carcinoma
what cancer are you more at risk at if you have chronic gastritis or H. pylori infection
gastric lymphoma
