Patgology Of The Stomach Flashcards
What are the inflammatory disorders of the stomach?
°Acute gastritis irritant chem injury Severe burns Shock Severe trauma Head injury
°Chronic gastritis
Autoimmune
Bacterial
Chemical (chronically ingest non-steroidal anti-inflammatory drugs, alcohol)
°Rare ones
Lymphomatic
Eosinophilic
Granulomatous
*What is autoimmune chronic gastritis?
Anti- parietal and anti- intrinsic factor antibodied produced which disturb stomach
Increased risk of malignancy and SACDC
Pernicacious anaemia, macrocytic due to vit B12 deficiency
*breaks down in spinal cord can lead to disabilities
What is H. Pylori associated Chronic Gastritis?
H. Pylori cam live within the gastric mucosa, destroys the epithelial cells.
Causes duodenal and gastric ulcer, gastric cancer and gastric lymphoma
What happens in chemical gastritis?
It involves direct injury to mucus layer by fat solvents. It breaks the cell membrane, hemce the cell breaks down and dies.
Marked epithelial regen,. Hyperplasia, congestion and little inflammation
Red stomach with lots of spots of inflammation
What is peptic ulceration?
It is a complication of imflammation.
Discontinuation of flat epithelial surface plus production of more acid. Hence the acid and gastric juices (pepsin) gets exposed to more deeped tissues and is therefore more toxic.
Long standing, deep and chronic
Areas predisposed to developing peptic ulcer
Upper part of duodenum, oesophageal-gastric junction, stomach (jnctn of body and antrum)
Pathogenesis of chronic duodenal ulcers
Increased attack (increased acid secretion, bacteria) and failure of defense (inability to cope with too much acid pdtn due to inability of epithelium to produce mucus)
In case of H. Pylori infection, it increases acid pdtn even more. Hence more corrosion, dysplasia and hyperplasia
Morphology of peptic ucers
Clear cut, pinched out, boundaries clear
Layered appearance
Increased collagen and scarring = stricture
Floor of …
Complications of peptic ulcers
Perforation Proliferation Haemorrhage Stenosis Intractable pain
What are the gastric tumours?
Benign polyps(heaps of cells like mushrooms, easily removed) :-
Hyperplastic polyps
Cystic fundic gland polyps
Malignant tumours:
Carcinomas
Lymphomas
Gastrointestinal stromal tumours (GISTs)
Epidemiology of gastric adenocarcinoma
High in developing countries (due to increased H. Pylori infection)
High in Japan(smoked fish), china, columbia and finland
Pathogenesis of gastric adenocarcinoma
Hy. Pylori infection - chronic gastritis - intestinal metaplasia/ atrophy - dysplasia - carcinoma
What are other premalignant conditions ass with gastric adenocarcinoma
Pernicioyd anaemia
Partial gastrectomy
…
..
What are the subtypes of gastric adenocarcinoma
Intestinal - well defined tumor, exophytic/ polypoid (raised rolled edges and the cancer lies in the centre - with pus, blood)
Diffuse type - spread out all over the place
Histology of gastric adenocarcinoma
Forms glands, rossettes of it
