Pathology of gastric diseases Flashcards
Which portion of the gastric mucosa varies? Which part remains the same?
Foveolar compartment=same
Glandular compartment=varies
What does the oxyntic mucosa produce?
acid and pepin
What are three congential lesions of the stomach?
- pancreatic heterotopia (pancreas doesn’t separate from teh stomach)
- hernias (increased risk of GERD)
- congenital hypertrophic pyloric stenosis (early projectile vomiting)
What are risk factors for acute gastritis?
NSAIDs, alcohol
bile reflux
smoking
severe hypotension or stress
What would you see in intestinal metaplasia?
Lots of mucin, producing cells
Which layer of the stomach contains major vessels?
The submucosa. If ulcer erode to this depth, can have hemorrhage
What is autoimmune gastritis?
Antibodies against parietal cells. Will see gastric atrophy and intestinal metaplasia. Also, endocrine cell hyperplasia
What are you at risk of developing if you have autoimmune gastritis?
Neuroendocrine tumors (i.e. carcinoids) Adenocarcinoma
How do you stain for gastric carcinoids?
chromogranin immunostaining
Menetrier disease
Hypertrophic Gastropathy=foveolar hyperplasia
What are four types of gastric polyps?
- hyperplastic
- Gastric fundic
- Peutz-Jeghers
- Adenomatous
Which type of polyp is malignant?
adenomatous polyp
What is gastric fundic polyp assoc’d with?
Familial adenomatous polyposis and PPIs
What does Peutz-Jeghers polyp look like?
Arborizing smooth muscle layer
What are four types of gastric malignancies?
Adenocarcinoma (90%)
Lymphoma
Neuroendocrine (carcinoid)
GI stromal tumor
What are the two types of gastric adenocarcinoma?
Intestinal:
- Dysplasia before
- arises in glands
- more common in men
Diffuse:
- Linitis plastica
- No dysplasia before
- Arises in individual cells, no discrete mass
What is the most important prognostic variable in gastric adenocarcinoma?
depth of invasion
How do you stage adenocarcinomas?
TNM
What is a common metastasis site for adenocarinoma of the stomach/
Virchow’s node
Krukenberg tumor:
Bilateral ovarian metastases
How does H pylori cause MALT lymphoma?
H pylori stimulates T cells
T cells activate B cells–>malignancy
How do you treat MALT lymphoma?
Antibiotics alone. But if cells have acquired t(11,18) then need to treat like a lymphoma
Where do gastric carcinoids arise from?
ECL cells
What kinds of cells are GI stromal tumors linked to?
Interstitial cells of cajal?
What mutations would you see in GI stromal tumors?
C-kit or PDGFR-alpha tyrosine kinases have activating mutations
How do you treat GI stromal tumors?
imatinib
