small intestine tumours Flashcards
why is the small intestine protected against malignancy
- high population of lymphoid tissue
- secretion of IgA
where is adenocarcinoma found
duodenum and jejunum
what is the most common tumour of the small intestine
adenocarcinoma
where are lymphomas found
ileum
what is the most common type of lymphoma
B cell type arising from MALT
what do most T cell lymphomas look like
ulcerated plaques or strictures in proximal small bowel
what are some factors that cause adenocarcinoma
- coeliac
- crohns
what type of lymphoma does coeliac disease cause
T cell type
what does lymphoma present with
- abdominal pain
- diarrhoea
- anorexia
- weight loss
- anaemia symptoms
- palpable mass
what investigations can be done for lymphoma
ultrasound followed by MRI
what does ultrasound detect in lymphoma
mass lesion
treatment of adenocarcinoma
surgically remove the segmental resection
where do carcinoid tumours originate
enterochromaffin cells
where is the most common types of carcinoid tumours
appendix and terminal ileum
what is done for treatment of carcinoid tumour
surgery
what can carcinoids present with
liver enlargement due to metastases
symptoms of carcinoid tumour
- induced bluish-red flushing
- abdominal pain
- recurrent watery diarrhoea
what do carcinoid tumours secrete
- serotonin (5-HT)
- bradykinin
- histamine
- prostaglandin
what secreted by carcinoid tumours causes the diarrhoea and cardiac complications
5-HT
what secreted by carcinoid tumours causes the blushing
bradykinin
what is used to diagnose carcinoid tumour
- ultrasound
- urine
- serum chromoganin A
what is seen on ultrasound of carcinoid tumour
presence of liver secondary deposits
what does urine show in carcinoid tumour
high concentration of 5-HT
what is used to treat carcinoid tumour
ocreotide
alleviates flushing and diarrhoea
what is Peutz-Jeghers syndrome
mucoocutaneous pigmentation and GI polyps
what kind of inheritance is Peutz-Jeghers syndrome
autosomal dominant inheritance
what is a characteristic is there of Peutz-Jeghers syndrome
brown buccal pigment
where can Peutz-Jeghers syndrome occur
anywhere in GI tract mostly in small bowel
what is treatment of Peutz-Jeghers syndrome
endoscopic polypectomy
what may be necessary to reach the polyps in Peutz-Jeghers syndrome
balloon enteroscopy
what is follow up for Peutz-Jeghers syndrome
yearly pan-endoscopy
