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PATHOLOGY > Rosai Chapter 14 - Stomach > Flashcards

Rosai Chapter 14 - Stomach Flashcards

1
Q

Superomedial margin of the stomach

A

Lesser curvature

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2
Q

Inferolateral margin of the stomach

A

Greater curvature

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3
Q

Mucin secreted by the gastric mucosa is almost entirely of:

A

Neutral type

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4
Q

Neutral-type mucin secreted by the gastric mucosa is positive for:

A

Periodic-acid Schiff (PAS)

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5
Q

Neutral-type mucin secreted by the gastric mucosa is negative for:

A

Alcian blue

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6
Q

IHCs of foveolar epithelium (2):

A
  • MUC1

- MUC5AC

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7
Q

IHC of foveolar glands:

A

-MUC6

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8
Q

Endocrine cells of the Pyloric mucosa of the stomach (3)

A
  • G cells
  • Enterochromaffin cells
  • D cells
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9
Q

Endocrine cell of the Fundic mucosa of the stomach

A

Enterochromaffin-like (ECL) cells

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10
Q

Most common endocrine cell of the Pyloric mucosa of the stomach

A

-G cells (50%)

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11
Q

Gastrin producing endocrine cell of the pyloric mucosa of the stomach

A

G cells

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12
Q

Serotonin producing endocrine cell of the pyloric mucosa of the stomach

A

Enterochromaffin cells

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13
Q

Somatostatin producing endocrine cell of the pyloric mucosa of the stomach

A

D cells

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14
Q

Histamine storing endocrine cell of the fundic mucosa of the stomach

A

ECL cells

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15
Q

Layers of Muscularis Mucosae

A

ICOL

  • Inner circular
  • Outer longitudinal
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16
Q

Layers of Muscularis propria

A

IOMCOL

  • Inner oblique
  • Middle circular
  • Outer longitudinal
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17
Q

The layer of muscularis propria that forms the pyloric sphincter at gastroduodenal junction

A

Middle circular

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18
Q

In what layer of the muscularis propria can you find the Auerbach (myenteric) plexus and Interstitial cells of Cajal?

A

Between the Middle Circular and Outer Longitudinal

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19
Q

Most common age of onset of Hypertrophic Pyloric Stenosis

A

-3 and 12 weeks

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20
Q

Main differential diagnosis of congenital hypertrophic pyloric stenosis

A

Pyloric atresia

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21
Q

This differential diagnosis of congenital hypertrophic pyloric stenosis is a genetically determined disease associated with Epidermolysis bullosa

A

Pyloric atresia

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22
Q

Two main features of Chronic Gastritis:

A
  • infiltration of the lamina propria by inflammatory cells; and eventually
  • Atrophy of the glandular epithelium
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23
Q

CHRONIC SUPERFICIAL GASTRITIS vs. CHRONIC ATROPHIC GASTRITIS:

-Inflammation is limited to foveolar region

A

Chronic superficial gastritis

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24
Q

CHRONIC SUPERFICIAL GASTRITIS vs. CHRONIC ATROPHIC GASTRITIS

-Absence of glandular atrophy

A

Chronic superficial gastritis

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25
Q

CHRONIC SUPERFICIAL GASTRITIS vs. CHRONIC ATROPHIC GASTRITIS

-Inflammation is more extensive

A

Chronic atrophic gastritis

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26
Q

CHRONIC SUPERFICIAL GASTRITIS vs. CHRONIC ATROPHIC GASTRITIS

-Presence of glandular atrophy

A

Chronic atrophic gastritis

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27
Q

Two types of metaplastic change in Chronic Gastritis:

A
  • Pyloric metaplasia of the fundic mucosa

- Intestinal metaplasia

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28
Q

Type of Metaplastic change in Chronic Gastritis:

-a replacement of the fundic-type glands by mucus-secreting glands

A

-Pyloric metaplasia of the fundic mucosa

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29
Q

Type of Metaplastic change in Chronic Gastritis:

-gradual process that proceeds as an advancing front along the fundic-pyloric junction and moves proximally toward the cardia

A

-Pyloric metaplasia of the fundic mucosa

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30
Q

Type of Metaplastic change in Chronic Gastritis:

-refers to the progressive replacement of the gastric mucosa by epithelium having the light and electron microscopic features of intestinal epithelium of either small or large bowel type, including goblet cells, absorptive (brush border) cells, Paneth cells, and a variety of endocrine cells

A

-Intestinal metaplasia

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31
Q

Two types of Intestinal Metaplasia

A
  • Complete (Type I)

- Incomplete (Type II)

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32
Q

Type of Intestinal Metaplasia:

-gastric mucosa changes to a pattern nearly identical to that of small bowel epithelium, with the development of villi and crypts in the most advanced cases

A

-Complete (Type I)

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33
Q

Type of Intestinal Metaplasia:

Histochemistry:

  • Sialomucin
  • small amounts: Sulfomucins and/or Neutral mucins
A

-Complete (Type I)

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34
Q

Type of Intestinal Metaplasia:

IHC:

  • Positive for MUC2
  • Decrease or Negative for MUC1, MUC5AC, and MUC6
A

-Complete (Type I)

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35
Q

Type of Intestinal Metaplasia:

H. pylori - absent in foci

A

-Complete (Type I)

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36
Q

Type of Intestinal Metaplasia:

-absorptive cells are absent, whereas columnar cells with the appearance of gastric foveolar cells are retained

A

-Incomplete (Type II)

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37
Q

Type of Intestinal Metaplasia:

Histochemistry:
-Positive for either neutral mucins (Type IIA) or sulfomucins (Type IIB)

A

-Incomplete (Type II)

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38
Q

Type of Intestinal Metaplasia:

IHC:
-Positive for MUC2 and mucins normally expressed in the stomach

A

-Incomplete (Type II)

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39
Q

Type of Intestinal Metaplasia:

H.pyori - may be present, foci

A

-Incomplete (Type II)

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40
Q

Two types of Chronic Gastritis

A
  • Type A or Immune

- Type B or Nonimmune

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41
Q

Type of Chronic Gastritis

-Less common

A

-Type A or Immune

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42
Q

Type of Chronic Gastritis

-usually affects the Fundus in a diffuse manner but spares the antrum

A

-Type A or Immune

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43
Q

Type of Chronic Gastritis

-Neuroendocrine hyperplasia

A

-Type A or Immune

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44
Q

Type A or Immune Chronic Gastritis is associated with (3):

A
  • Antibodies to Parietal cells
  • Hypochlorhydria or Achlorhydria
  • Increased serum Gastrin
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45
Q

Type of Chronic Gastritis

-More frequent

A

-Type B or Nonimmune

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46
Q

Type of Chronic Gastritis

-begins in the antrum and progresses proximally

A

-Type B or Nonimmune

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47
Q

Two subdivisions of Type B or Nonimmune Chronic Gastritis

A
  • Hypersecretory gastritis

- Environmental gastritis

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48
Q

This subdivision of Type B or Nonimmune chronic gastritis is restricted to the antrum and associated with hyperchlorhydria and often duodenal peptic ulceration

A

-Hypersecretory gastritis

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49
Q

This subdivision of Type B or Nonimmune chronic gastritis involves BOTH Antrum and Fundus in an initially patchy and eventually diffuse distribution

A

-Environmental gastritis

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50
Q

Ultimate cause for ulceration in peptic ulcers

A

-Acid peptic digestion

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51
Q

This form of acute gastric ulcer is seen following surgery or trauma

A

-Stress ulcer

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52
Q

This form of acute gastric ulcer is seen in patients with CNS injury or disease

A

Cushing ulcer

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53
Q

This form of acute gastric ulcer is seen as a complication of long-term steroid therapy

A

Steroid ulcer

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54
Q

This form of acute gastric ulcer is seen in patients with extensive burns

A

Curling ulcer

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55
Q

Ulcer that always occurs in an achlorhydric zone of mucosa (i.e. an area of stomach lined by pyloric-type mucosa)

A

Chronic peptic ulcer

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56
Q

Microscopically, chronic peptic ulcer will show four more or less distinct layers (4):

A
  • a surface coat or purulent exudate, bacteria, and necrotic debris
  • Fibrinoid necrosis
  • Granulation tissue
  • Fibrosis which can replace the muscle wall and even extend into the subserosa
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57
Q

Morphologic changes when ulcers are infected by H. pylori (4):

A
  • Loss of the apical portion and dropout of epithelial cells
  • Epithelial pits
  • Erosions
  • Cellular tufts
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58
Q

Most common cyst and are often associated with intestinal metaplasia

A

Intramucosal cysts

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59
Q

other name of Submucosal cysts

A

Gastritis cystica profunda

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60
Q

Bezoar composed of hair

A

Trichobezoar

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61
Q

Bezoar composed of vegetable matter

A

Phytobezoar

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62
Q

More than 85% of this bezoar is caused by ingestion of unrippened persimmons

A

Phytobezoar

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63
Q

Factors favoring the development of Bezoars (3):

A
  • Lack of teeth
  • Vagotomy or Previous gastric surgery
  • Obstructing lesions of the gastric outlet
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64
Q

other name of Aneurysms of gastric vessel (2):

A
  • Dieulafoy disease

- Caliber-persistent artery

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65
Q

other name of Gastric antral vascular ectasia (GAVE):

A

“Watermelon stomach”

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66
Q

Gastric hyperplastic polyps tend to arise in a background of (5):

A
  • Hypochlorhydria
  • Low levels of Pepsinogen I
  • Hypergastrinemia
  • Chronic gastritis
  • Gastric atrophy
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67
Q

Distinguishing microscopic feature of Fundic gland polyps

A

Microcysts lined by fundic epithelium

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68
Q

Key molecular alteration in Sporadic fundic gland polyp

A

activating mutation of the Beta-catenin gene

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69
Q

Key molecular alteration in Familial fundic gland polyp (associated with FAP)

A

somatic, 2nd hit alterations in the APC gene

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70
Q

This other type of gastric epithelial polypoid lesion arises against a background of atrophic gastritis and represents an early stage of hyperplastic polyp

A

Foveolar hyperplasia

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71
Q

This other type of gastric epithelial polypoid lesion is associated with Peutz-Jeghers syndrome and juvenile polyposis

A

Hamartomatous polyps

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72
Q

other names of Menetrier disease (3)

A
  • Hypertophic or Hyperplastic gastropathy
  • Giant hypertrophic gastritis
  • Giant hypertophy of gastric rugae
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73
Q

Two forms of Menetrier disease

A
  • Typical form

- Localized form

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74
Q

This form of Menetrier disease has diffuse involvement of the fundic portion, with sparing of the antrum

A

-Typical form

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75
Q

This form of Menetrier disease is well-circumscribed cerebroid mass, either in the fundus or the antrum

A

-Localized form

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76
Q

Two forms of Gastric dysplasia

A
  • Intestinal type (Adenomatous, Type I)

- Gastric type (Foveolar, Type II)

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77
Q

Two categories of Gastric dysplasia

A
  • Low grade

- High grade (aka CIS)

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78
Q

Most common subtype of gastric carcinoma

A

intestinal-type adenocarcinoma

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79
Q

Secretory product of most gastric adenocarcinoma, intestinal-type

A

Acid mucosubstance

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80
Q

Acid mucosubstance in intestinal-type gastric adenocarcinoma can be detected by what stains (3)?

A
  • Mayer mucicarmine
  • Alcian blue
  • Colloidal iron stains
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81
Q

Secretory product of most gastric adenocarcinoma, diffuse-type (2)

A
  • Acidic; or

- Neutral (predominating)

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82
Q

Main mucin types in gastric adenocarcinoma (IHC):

-Intestinal-type

A

MUC1

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83
Q

Main mucin types in gastric adenocarcinoma (IHC):

-Diffuse-type

A

MUC5AC

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84
Q

Main mucin types in gastric adenocarcinoma (IHC):

-Mucinous-type

A

MUC2

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85
Q

Main mucin types in gastric adenocarcinoma (IHC):

-Unclassified-type

A

MUC5B

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86
Q

Main mucin types in gastric adenocarcinoma based on location (IHC):

-Antral tumors

A

MUC5AC

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87
Q

Main mucin types in gastric adenocarcinoma based on location (IHC):

-Cardia tumors

A

MUC2

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88
Q

Hepatoid Adenocarcinoma of the Stomach vs. HCC of the liver

-Positive for PLUNC protein

A

Hepatoid Adenocarcinoma of the Stomach

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89
Q

Hepatoid Adenocarcinoma of the Stomach vs. HCC of the liver

-Positive for SALL4

A

Hepatoid Adenocarcinoma of the Stomach

90
Q

Hepatoid Adenocarcinoma of the Stomach vs. HCC of the liver

-Negative for PLUNC protein

A

HCC of the liver

91
Q

Hepatoid Adenocarcinoma of the Stomach vs. HCC of the liver

-Negative for SALL4

A

HCC of the liver

92
Q

other name of Lymphoepithelioma-like carcinoma

A

Undifferentiated carcinoma with intense lymphoid infiltration

93
Q

other name of Sarcomatoid carcinoma

A

Carcinosarcoma

94
Q

Isolated nodal metastasis in the left supraclavicular region

A

-Trousseau sign or Virchow node

95
Q

Three types of gross appearances of early carcinoma at endoscopy

A
  • Protruding or Type I
  • Superficial or Type II
  • Excavated or Type III
96
Q

Type of gross appearance of early carcinoma at endoscopy:

  • Polypoid
  • Nodular
  • Villous
A

-Protruding or Type I

97
Q

Type of gross appearance of early carcinoma at endoscopy:

  • Elevated
  • Flat
  • Depressed
A

-Superficial or Type II

98
Q

Most frequent sites of distant metastases of gastric carcinomas (5):

A
  • Liver
  • Peritoneum
  • Lung
  • Adrenal gland
  • Ovary
99
Q

Remains the strongest prognostic indicator of gastric carcinomas

A

Anatomic stage

100
Q

Single best predictive indicator of prognosis

A

Lymph node status

101
Q

Predominating cell in this Gastric WDNET

-Solitary

A

-G-cells (Gastrinoma)

102
Q

Predominating cell in this Gastric WDNET

-Located in the Antrum

A

-G-cells (Gastrinoma)

103
Q

Predominating cell in this Gastric WDNET

-Non-argentaffin

A

Both G-cells and ECL cells

104
Q

Predominating cell in this Gastric WDNET

-Non-argyrophilic

A

-G-cells (Gastrinoma)

105
Q

Predominating cell in this Gastric WDNET

-immunoreactive for Gastrin

A

-G-cells (Gastrinoma)

106
Q

Predominating cell in this Gastric WDNET

-sometimes associated with peptic ulcer

A

-G-cells (Gastrinoma)

107
Q

Predominating cell in this Gastric WDNET

-Multiple, often polypoid

A

-ECL cells

108
Q

Predominating cell in this Gastric WDNET

-distributed throughout FUNDUS

A

-ECL cells

109
Q

Predominating cell in this Gastric WDNET

-Strongly argyrophilic

A

-ECL cells

110
Q

Predominating cell in this Gastric WDNET

-Nonreactive for gastroduodenopancreatic hormones

A

-ECL cells

111
Q

Predominating cell in this Gastric WDNET

-accompanied by diffuse hyperplasia of similar cells in the surrounding mucosa

A

-ECL cells

112
Q

This type of ECL cell tumor of the stomach is associated with chronic atrophic gastritis

A

-Type I

113
Q

This type of ECL cell tumor of the stomach is associated with MEN I

A

-Type II

114
Q

This type of ECL cell tumor of the stomach is sporadic

A

-Type III

115
Q

Main features that relate to prognosis of ECL cell tumors of the stomach (5)

A

“DM TAM”

  • Direct invasion
  • Metastases
  • Tumor size
  • Angioinvasion
  • Mitotic activity and/or Ki-67 index
116
Q

staining pattern of CD117 (c-Kit) in GISTs

A

-Membranous and Cytoplasmic

117
Q

staining pattern of CD117 (c-Kit) in Mesenchymal tumors other than GIST

A

-Cytoplasmic with a coarse granular pattern

118
Q

Characteristics of Kit-negative GISTs (5):

A

“My POEM”

  • Myxoid stroma
  • harbor PDGFRA mutations
  • arise in the Omentum
  • Epithelioid morphology
  • numerous Mast cells
119
Q

Most common symptoms of abdominal GISTs (2):

A
  • Abdominal pain

- Melena

120
Q

Carney triad

A
  • GIST
  • Pulmonary chondroma
  • Extra-adrenal paraganglioma
121
Q

Carney-Stratakis syndrome

A

-GIST with associated familial paraganglioma

122
Q

Fibromatosis (Desmoid tumor) vs. GIST

  • Extensively involve the GI wall
  • Positive cytoplasmic staining of CD117
A

-Fibromatosis (Desmoid tumor)

123
Q

SFT vs GIST

  • Positive: CD34 & STAT6
  • Negative: CD117 & DOG1
A

SFT

124
Q

SFT vs. GIST

  • Positive: CD34, CD117, & DOG1
  • Negative: STAT6
A

GIST

125
Q

True smooth muscle tumors vs GIST

  • more densely eosinophilic cytoplasm
  • stain strongly for smooth muscle markers (SMA, Desmin, h-Caldesmon)
A

-True smooth muscle tumors

126
Q

Gastric Schwannomas vs GIST

  • Peripheral lymphoid infiltrate
  • Strong S100 positivity
A

-Gastric Schwannomas

127
Q

Most common sites of metastases of malignant GISTs (3)

A
  • Liver
  • Peritoneum
  • Lungs
128
Q

Prognostic parameters in GISTs (3):

A
  • Tumor site
  • Tumor size
  • Mitotic index (mitoses/5 sq. mm)
129
Q

Compositions of MALT (3):

A
  • Lymphoid nodules (which in the ileum form the Peyer patches)
  • Lymphocytes and Plasma cells in the Lamina propria
  • Intraepithelial lymphocytes
130
Q

True intranuclear eosinophilic inclusions made up of immunoglobulins

A

Dutcher bodies

131
Q

Most helpful diagnostic clues favoring a marginal zone lymphoma from chronic gastritis and other low-grade lymphomas (3):

A
  • Cytologic atypia
  • Dutcher bodies
  • Lymphoepithelial lesions
132
Q

IHC useful for highlighting lymphoepithelial lesions in MALT-type Lymphoma

A

-Cytokeratins

133
Q

Characteristics of MALT lymphomas harboring API2-MALT1 fusion or t(11;18) translocation (3):

A
  • predicts a lack of response to anti-Helicobacter therapy
  • can protect against transformation to a large B-cell lymphoma
  • associated with higher-stage disease
134
Q

Mantle cell lymphoma vs. Follicular Lymphoma

Positive for:

  • CD5
  • Cyclin D1
A

Mantle cell lymphoma

135
Q

Mantle cell lymphoma vs. Follicular Lymphoma

Positive for:

  • CD10
  • BCL6
A

Follicular Lymphoma

136
Q

IHC which highlights the areas of large cell transformations, which portends a worse prognosis

A

-BCL6

137
Q

Main microscopic differential diagnosis of Large B-cell lymphoma

A

Undifferentiated carcinoma

138
Q

Features favoring a diagnosis of Lymphoma over carcinoma (3):

A
  • lack of continuity between epithelium and tumor cells
  • lack of suggestion of an acinar pattern
  • preservation of muscularis mucosae fibers
139
Q

Most common form of treatment failure in Large B-cell Lymphoma

A

Distant disease

140
Q

Favorable prognostic features of Large B-cell Lymphoma (4):

A
  • Small tumor size
  • Superficial mural invasion
  • Presence of low-grade MALT-type areas
  • Absence of regional lymph node involvement
141
Q

other name of Plexiform fibromyxoma

A

Plexiform angiomyxoid myofibroblastic tumor

142
Q

Two most common forms of gastric Germ cell tumors (2):

A
  • Choriocarcinoma

- Yolk sac tumor

143
Q

Metastatic Lobular carcinoma of the Breast vs. Diffuse-type Adenocarcinoma of the Stomach

-Presence of tumor cells with a bull’s eye appearance (indicative of intracellular lumina)

A

Metastatic Lobular carcinoma of the Breast

144
Q

Metastatic Lobular carcinoma of the Breast vs. Diffuse-type Adenocarcinoma of the Stomach

Positive:

  • Hormone receptors
  • GCDFP-15
  • GATA3
A

Metastatic Lobular carcinoma of the Breast

145
Q

Metastatic Lobular carcinoma of the Breast vs. Diffuse-type Adenocarcinoma of the Stomach

-Loss of E-cadherin

A

Metastatic Lobular carcinoma of the Breast

146
Q

Metastatic Lobular carcinoma of the Breast vs. Diffuse-type Adenocarcinoma of the Stomach

Positive:

  • CK20, DAS-1
  • MUC2, MUC5AC, MUC6
  • CDX2
A

Diffuse-type Adenocarcinoma of the Stomach

147
Q

The junction between the corpus and the antrum is marked on the serosal side by a notch in the lesser curvature known as the

A

Incisura

148
Q

Internally, the mucosa is thrown into coarse folds called

A

Rugae

149
Q

Two major compartments of the mucosa

A
  • Foveolar

- Glandular

150
Q

Origin of the blood supply of the stomach (3):

A
  • Celiac axis
  • Hepatic artery
  • Splenic artery
151
Q

Lymphatic drainage of Cardia and most of lesser curvature

A

-Left gastric nodes

152
Q

Lymphatic drainage of Pylorus and distal lesser curvature (2)

A
  • Right gastric nodes

- Hepatic nodes

153
Q

Lymphatic drainage of Proximal portion of the greater curvature

A

Pancreaticosplenic nodes in the splenic hilum

154
Q

Lymphatic drainage of Distal portion of greater curvature (2)

A
  • right gastroepiploic nodes in greater omentum

- pyloric nodes at the head of the pancreas

155
Q

may result from the ingestion of alcohol, salicylates, and other anti-inflammatory drugs, or by the reflux of bile salts

A

Acute gastritis

156
Q

It is more often referred to as reactive or chemical gastropathy, as there is typically little inflammation, and as such, there is little gastritis

A

Acute gastritis

157
Q

an acute life-threatening condition usually engrafted on a background of chronic gastritis

A

Hemorrhagic gastritis

158
Q

an exceptionally rare condition which is characterized by a thick subepithelial collagen band associated with a mucosal inflammatory infiltrate often rich in eosinophils

A

Collagenous gastritis

159
Q

presents in a gastric biopsy as infiltration of the lamina propria by eosinophils, which in severe cases is diffuse and accompanied by degenerative and regenerative changes of the surface and foveolar epithelium.

A

Allergic/Eosinophilic Gastroenteritis

160
Q

DUODENAL vs GASTRIC ulcer

-More common

A

Duodenal ulcer

161
Q

DUODENAL vs GASTRIC ulcer

-classically associated with acid hypersecretion

A

Duodenal ulcer

162
Q

DUODENAL vs GASTRIC ulcer

-secrete either low normal or below normal amounts of acid

A

Gastric ulcer

163
Q

Characteristics of Aneurysms of gastric vessels (4):

A
  • usually Single
  • located in the Submucosa
  • usually high on the Lesser curvature
  • characterized by a Large tortuous vessel surmounted by a small defect in the overlying mucosa
164
Q

an acquired vascular disease of the stomach that may result in blood loss and iron deficiency anemia

A

Gastric antral vascular ectasia (GAVE or “watermelon stomach”)

165
Q

appears as a small yellow intramucosal lesion characterized by the accumulation of
neutral fat in foamy histiocytes in the lamina propria

A

Xanthoma (xanthelasma)

166
Q

Secondary to the administration of aluminum-containing antacids or sucralfate therapy in organ transplant patients

A

Mucosal calcinosis

167
Q

Polyps which are randomly distributed in the stomach and are generally small, sessile, and multiple, with a smooth or slightly lobulated contour

A

Hyperplastic polyps

168
Q

Type of Polyp

Micro: they show elongation, tortuosity, and dilation (often cystic) of the gastric foveolae, with a component of pyloric or—less commonly—fundic type of glands in the deeper portion.
The stroma, usually prominent, is characterized by edema, patchy fibrosis, inflammatory cells, and scattered smooth muscle bundles from the muscularis mucosae.

A

Hyperplastic polyps

169
Q

Characteristics of Adenomas (3)

A
  • usually Antral in location
  • generally Single and Large
  • either Sessile or Pedunculated
170
Q

Characteristics of Pyloric gland adenoma (5)

A
  • frequently develop in the setting of Chronic gastritis with intestinal metaplasia and/or atrophy
  • most common in Elderly patients
  • slight Female predilection
  • most often arise in the Fundus/Body
  • usually less than 2 cm
171
Q

Type of Polyp

Micro: composed of tightly packed tubules comprised of cuboidal or columnar cells with pale to eosinophilic cytoplasm.
They lack an apical cap of mucin.

A

Pyloric gland adenoma

172
Q

may arise in the setting of chronic gastritis or familial adenomatous polyposis (FAP) and is composed of oxyntic glands with parietal and chief cells.

A

Oxyntic gland adenoma

173
Q

incredibly common and present as multiple small (average size 2.3 mm) polypoid projections in the gastric fundus or body

A

Fundic gland polyp

174
Q

Fundic gland polyps can occur in (3)

A
  • sporadic form or present in patients with the Zollinger–Ellison syndrome
  • those on long-term treatment with proton pump inhibitors
  • those affected by FAP
175
Q

Type of Polyp

Micro: this lesion is centered in the submucosa and is
characterized by a vascular and fibroblastic proliferation (often in a whorl-like arrangement around blood vessels) and a polymorphic inflammatory response, usually dominated by eosinophils

A

Inflammatory fibroid polyp

176
Q

Disease characterized by Hypochlorhydria or Achlorhydria and often impressive hypoproteinemia

A

Menetrier disease

177
Q

occur most often in areas of mucosal injury, resulting in epithelial cells which are immature, with basophilic cytoplasm, slightly hyperchromatic nuclei, and reduced or absent mucus secretion

A

Regenerative changes

178
Q

Carcinoma characterized by prominent glandular formations and abundant mucin deposition, nearly all of which is extracellular

A

Mucinous adenocarcinoma

179
Q

a type of gastric carcinoma having both glandular and hepatocellular differentiation, with frequent admixtures between the two components

A

Hepatoid adenocarcinoma

180
Q

a tumor of dualcomposition, with epithelial elements (usually glandular) intermingling with a sarcoma-like spindle cell component

A

Sarcomatoid carcinoma

181
Q

carcinoma confined to the mucosa or to the mucosa and submucosa (not extending into the muscularis externa), regardless of the status of the regional lymph nodes

A

“Early” gastric carcinoma

182
Q

Bilateral ovarian metastases from the diffuse type of gastric carcinoma

A

Krukenberg tumor

183
Q

Definitions of AJCC TNM for squamous cell carcinoma and adenocarcinoma

Primary Tumor (T) category:
Tumor cannot be assessed
A

Tx

184
Q

Definitions of AJCC TNM for squamous cell carcinoma and adenocarcinoma

Primary Tumor (T) category:
No evidence of primary tumor
A

T0

185
Q

Definitions of AJCC TNM for squamous cell carcinoma and adenocarcinoma

Primary Tumor (T) category:
High-grade dysplasia, defined as malignant cells confined to the epithelium by the basement membrane
A

Tis

186
Q

Definitions of AJCC TNM for squamous cell carcinoma and adenocarcinoma

Primary Tumor (T) category:
Tumor invades the lamina propria or muscularis mucosae
A

T1a

187
Q

Definitions of AJCC TNM for squamous cell carcinoma and adenocarcinoma

Primary Tumor (T) category:
Tumor invades the submucosa
A

T1b

188
Q

Definitions of AJCC TNM for squamous cell carcinoma and adenocarcinoma

Primary Tumor (T) category:
Tumor invades the muscularis propria
A

T2

189
Q

Definitions of AJCC TNM for squamous cell carcinoma and adenocarcinoma

Primary Tumor (T) category:
Tumor penetrates the subserosal connective tissue without invasion of the visceral peritoneum or adjacent structures
A

T3

190
Q

Definitions of AJCC TNM for squamous cell carcinoma and adenocarcinoma

Primary Tumor (T) category:
Tumor invades the serosa (visceral peritoneum)
A

T4a

191
Q

Definitions of AJCC TNM for squamous cell carcinoma and adenocarcinoma

Primary Tumor (T) category:
Tumor invades adjacent structures/organs
A

T4b

192
Q

Definitions of AJCC TNM for squamous cell carcinoma and adenocarcinoma

Regional Lymph Nodes (N) category:
Regional lymph nodes cannot be assessed

A

Nx

193
Q

Definitions of AJCC TNM for squamous cell carcinoma and adenocarcinoma

Regional Lymph Nodes (N) category:
No regional lymph node metastasis

A

N0

194
Q

Definitions of AJCC TNM for squamous cell carcinoma and adenocarcinoma

Regional Lymph Nodes (N) category:
Metastasis in one or two regional lymph nodes

A

N1

195
Q

Definitions of AJCC TNM for squamous cell carcinoma and adenocarcinoma

Regional Lymph Nodes (N) category:
Metastasis in three to six regional lymph nodes

A

N2

196
Q

Definitions of AJCC TNM for squamous cell carcinoma and adenocarcinoma

Regional Lymph Nodes (N) category:
Metastasis in 7-15 regional lymph nodes

A

N3a

197
Q

Definitions of AJCC TNM for squamous cell carcinoma and adenocarcinoma

Regional Lymph Nodes (N) category:
Metastasis in 16 or more regional lymph nodes

A

N3b

198
Q

Definitions of AJCC TNM for squamous cell carcinoma and adenocarcinoma

Distant Metastais (M) category:
Distant metastasis
A

M1

199
Q

Definitions of AJCC TNM for squamous cell carcinoma and adenocarcinoma

Distant Metastais (M) category:
No distant metastasis
A

M0

200
Q

Definitions of AJCC TNM for squamous cell carcinoma and adenocarcinoma

Primary Tumor (T) category:
there is perforation of the visceral peritoneum covering the gastric ligaments or the omentum
A

T4

201
Q

Definitions of AJCC TNM for squamous cell carcinoma and adenocarcinoma

Primary Tumor (T) category:
A tumor may penetrate the muscularis propria with extension into the gastrocolic or gastrohepatic ligaments, or into the greater or lesser omentum, without perforation of the visceral peritoneum covering these structures
A

T3

202
Q

The adjacent structures of the Stomach (10)

A
  • spleen,
  • transverse colon,
  • liver,
  • diaphragm,
  • pancreas,
  • abdominal wall,
  • adrenal gland,
  • kidney,
  • small intestine, and
  • retroperitoneum
203
Q

made up of WDNETs admixed with a glandular (exocrine) component

A

Composite tumors

204
Q

Characteristics of GISTs from Carney triad or Carney-Stratakis syndrome (8)

A
  • Young patients
  • Female
  • Multinodular growth pattern
  • Epithelioid morphology
  • often LN mets
  • indolent clinical behavior
  • mutation in succinate-dehydrogenase complex of genes (SDH deficient)
  • loss of staining of SDHB
205
Q

Characteristics of Gastric GIST with Spindle cells, low risk (5)

A

-bland spindle cells arranged in packets or whorls with normochromatic nuclei,
-perinuclear vacuoles,
-little mitotic activity (fewer than 5 mitotic figures/5 sq. mm ),
-sometimes nuclear palisading resembling
that seen in schwannoma and collagenous stroma,
-occasionally with dystrophic calcification

206
Q

Characteristics of Gastric GIST with Spindle cells, high risk (3)

A
  • atypical spindle cells arranged into fascicles with easily identifiable mitotic figures,
  • necrosis, and
  • mucosal invasion
207
Q

Characteristics of Gastric GIST with Epithelioid cells, low risk (5)

A
  • abundant eosinophilic or clear cytoplasm,
  • multinucleation,
  • rare mitotic figures,
  • abundant stroma, and
  • no necrosis or mucosal invasion
208
Q

Characteristics of Gastric GIST with Epithelioid cells, high risk (4)

A
  • highly cellular tumors with high-grade nuclei,
  • less cytoplasm,
  • numerous mitotic figures and
  • show evidence of necrosis and/or mucosal invasion
209
Q

the term that has been suggested for a peculiar biphasic epitheliomesenchymal gastric tumor which resembles synovial sarcoma but lacks the classic chromosomal translocation of the latter

A

Gastroblastoma

210
Q

This tumor is usually located in the antrum and characterized microscopically by
a plexiform intramural growth with multiple micronodules containing paucicellular to moderately cellular myxoid, collagenous, and fibromyxoid areas

A

Plexiform fibromyxoma

211
Q

FAVORABLE or UNFAVORABLE prognostic indicator of gastric carcinoma:

-Japanese ethnicity

A

Favorable

212
Q

FAVORABLE or UNFAVORABLE prognostic indicator of gastric carcinoma:

-Female gender

A

Favorable

213
Q

FAVORABLE or UNFAVORABLE prognostic indicator of gastric carcinoma:

-Younger patient age at diagnosis

A

Unfavorable

214
Q

FAVORABLE or UNFAVORABLE prognostic indicatorof gastric carcinoma:

-Small tumor size

A

Favorable

-may be linked to depth of invasion

215
Q

FAVORABLE or UNFAVORABLE prognostic indicatorof gastric carcinoma:

-presence of Pushing margin

A

Favorable

216
Q

FAVORABLE or UNFAVORABLE prognostic indicatorof gastric carcinoma:

-presence of Infiltrating margins

A

Unfavorable

217
Q

Most common type of gastric WDNET

A

ECL cell tumor

218
Q

a tyrosine kinase receptor normally expressed by the interstitial cells of Cajal, mast cells, and germ cells

A

KIT

219
Q

The presence and type of this KIT mutation has the highest response to the tyrosine kinase inhibitor imatinib mesylate (Gleevac; Glivec)

A

-Exon 11 mutations

220
Q

The presence and type of this KIT mutation has the lowest response to the tyrosine kinase inhibitor imatinib mesylate (Gleevac; Glivec)

A

-wild-type phenotype

PATHOLOGY (26 decks)

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