pathology - stomach Flashcards
causes of chronic gastritis
autoimmune
bacteria (H.Pylori)
Chemical
corpus =
body
- Oxyntic glands: Found in the
fundus and body of the stomach.
Pyloric glands: Found in the
pyloric antrum,
describe autoimmune gastritis and how that is associated with pernicious anaemia
- Associated with pernicious anaemia
- Anti-parietal and anti-intrinsic factor antibodies
- Loss of gastric parietal cells and gastric atrophy
- Moderate to severe inflammation
- Intestinal metaplasia
- Increased risk of malignancy: gastric adenocarcinoma and neuroendocrine tumours
- Macrocytic anaemia
- B12 deficiency – subacute combined degeneration of spinal cord
see notes in oneNote
H.ylori associated chronic gastritis complications
Complications:
Ulceration
Atrophy
Intestinal metaplasia
Gastric cancer
Mucosal associated lymphoid tissue (MALT) lymphoma
aitiology of chemical gastritis
Aetiology:
NSAIDs
Alcohol
Bile reflux
Direct injury to mucous layer by fat solvents
Causes marked epithelial regeneration, hyperplasia, congestion
Minimal inflammation
Can lead to erosions/ulcers
WHAT is peptic ulceration
Well demarcated “punched out” edges
Breach in mucosa
Due to injury by acid/pepsin
gastric acid - H.Pylori
duodenal ulcers and their cause
Disruption in equilibrium between gastric acid and protective factors (mucin and bicarbonate)
Most have history of NSAID use/H. pylori
H. pylori: inhibits somatostatin, increased gastrin secretion, increased hydrogen ion delivery to duodenum.
Direct spread of H.pylori to duodenum reduced HCO3 production.
NSAIDs: inhibits COX1/2, decreases prostaglandin production, increases risk of mucosal erosion.
complications of peptic ulcer
Perforation
Haemorrhage
Stenosis
Pain
which gastric tumors are benign and which are malignant
Benign
Polyps
Hyperplastic polyps
Cystic fundic gland polyps
Malignant:
Carcinomas
Lymphoma
GIST: gastrointestinal stromal tumour
describe the aetiology of gastric adenocarcinoma
Aetiology:
H.pylori:
Chronic gastritis
Gastric atrophy
Intestinal metaplasia
Dysplasia
Adenocarcinoma
Other Pre-Malignant Conditions: Pernicious anaemia/autoimmune gastritis Partial gastrectomy Lynch syndrome Menetrier’s disease
HOWEVER, all gastric ulcers must be regarded as potentially malignant.
true or false
true
words to describe a gastric adenocarcinoma
localised, polypoidal ,fungating tumor, diffuse, signet ring sign, desmoplastic
tumor spread of gastric adenocarcinoma which trascoelomic can present in the …. and it is called ….
Transcoelomic: tumour enters peritoneal cavity and can spread to ovaries Kruckenberg tumour
what is a gastric lymphoma MALToma
Diffuse lymphocytic infiltrate comprising small lymphocytes which attack the gastric pits
what is GIST
Gastrointestinal stromal tumour
Sarcoma of the GI tract
Derived from gut pacemaker cells (interstitial cells of Cajal)
These cells generate electric signals which drive rhythmic contractions of smooth muscle, enabling GI motility + digestion
Low grade malignancy
Usually require surgery
Most have mutations in c-kit gene (tyrosine kinase) can be treated with tyrosine kinase inhibitors
