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GI > Week 10 - Malignancy > Flashcards

Week 10 - Malignancy Flashcards

1
Q

What are the characteristic signs of oesophageal cancer?

A
  • Dysphagia

- Weight loss

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2
Q

How do you investigate a suspected oesophageal carcinoma?

A
  • Endoscopy
  • Biopsy
  • Barium swallow
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3
Q

What is the commonest type of oesophageal carcinoma?

A

-Squamous cell carcinoma

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4
Q

Where does adenocarcinoma of the oesophagus occur?

A

-Lower thrid

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5
Q

Why is the prognosis for oesophageal cancer poor?

A
  • Many present at late stages
  • Can spread directly through oesophageal wall
  • Many patients are elderly and not suitable for resection
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6
Q

Describe the prognosis of gastric cancer

A

-Poor with less than 20% 5 year survival

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7
Q

Does gastric cancer affect females or males more?

A

-males

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8
Q

What bacteria is associated with gastric cancer and strongly with gastric lymphoma?

A

-H.pylori

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9
Q

What are the clinical features of gastric cancer?

A
  • Vague symptoms
  • Vomiting
  • Weightloss
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10
Q

How do you investigate suspected gastric cancer?

A
  • Endoscopy
  • Biopsy
  • Barium
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11
Q

Describe the macroscopic features of a gastric cancer

A

-Fungating, ulcerating, infiltrative

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12
Q

What are the two types of gastric cancer?

A
  • Intestinal

- Diffuse

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13
Q

What is characteristic histologically of diffuse gastric cancer?

A
  • Signet ring cells full of mucin

- Cells arranged singly or in small groups

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14
Q

How does gastric cancer spread?

A
  • Directly
  • Lymph nodes
  • Haematogenous to liver
  • Transcoelomic to peritoneum/ovaries
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15
Q

What are krunkenberg tumours?

A

-Tumours of the overy which have metastasised from a primary site

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16
Q

What are the possible treatments for gastric cancer?

A
  • Surgery
  • Chemotherapy
  • Herceptin
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17
Q

What is the most common GI lymphoma?

A

-Gastric lymphoma

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18
Q

What lymph nodes involvement is associated with gastric cancer?

A

-Virchows node (left supraclavicular)

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19
Q

What are gastro-intestinal stromal tumours?

A

-Mesenchymal neoplasm which mainly occurs in the stomach

20
Q

What types of tumours occur in the large intestine?

A
  • Adenomas
  • adenocarcinomas
  • Polyps
  • anal carcinoma
21
Q

Describe the histiological features of an adenoma

A

-Can be sessile or pedunculated with a variable degree of dysplasia

22
Q

Name a genetic condition associated with adenomas

A

-Familial adenomatous polyposis

23
Q

What is the adenoma-carcinoma sequence?

A

-The stepwise development of adenocarcinomas from adenomas

24
Q

Describe features of right sided colorectal adenocarcinomas

A

-Fungating and unlikely to cause obstruction

25
Q

Describe features of left sided colorectal adenocarcinomas

A

-Stenotic and likely to cause obstruction

26
Q

Where do colorectal adenocarcinomas commonly occur?

A

-Distally in rectum and sigmoid

27
Q

What is an applecore stricture characteristic off?

A

-Colorectal adenocarcinoma

28
Q

How do colorectal adenocarcinomas spread?

A
  • Directly through the bowel wall to adjacent organs
  • Lympatics
  • Portal system to liver
29
Q

Describe dukes staging

A
  • A-> in the wall
  • B-> through the wall
  • C-> involves lymph nodes
30
Q

At what age do adenocarcinomas usually present?

A

-60-70

31
Q

Describe some risk factors for colorectal adenocarciomas

A
  • Slow transit time
  • Low residue diet
  • High fat intake
  • Genetic predisposition
32
Q

What metastases are common in advanced colorectal carcinoma?

A

-Liver

33
Q

Name 3 other large intestinal tumours besides adencarcinoma

A
  • Carcinoid tumour
  • Lymphoma
  • Stromal tumour (lyomyoma)
34
Q

Why is the prognosis of pancreatic carcinoma so poor?

A
  • Very difficult to diagnose until very late stage

- Early symptoms are vague

35
Q

What are the presenting features of pancreatic tumour?

A
  • Weight loss
  • Jaundice
  • Trousseau’s sign
36
Q

Where do most pancreatic carcinomas occur?

A

-In the head

37
Q

How does a pancreatic carcinoma appear on inspection?

A
  • Pale firm mass until cut

- Inside is necrotic, haemorrhagic

38
Q

In what cells do pancreatic tumours most often arise?

A

-Ductal

39
Q

Why can pancreatic cancer give a silvery stool?

A

-Malnutrition and lack of bile

40
Q

What types of islet cell tumours are there?

A
  • Insulinoma
  • Glucagonoma
  • VIPoma
  • Gastrinoma
41
Q

Which clinical presentation is caused by a gastrinoma?

A

-Zollinger-ellison syndrome

42
Q

Name 2 benign tumours of the liver

A
  • Hepatic adenoma

- Haemangioma

43
Q

Name 2 malignant tumours of the liver

A
  • Hepatocellular carcinoma

- Cholangiocarcinoma

44
Q

What is the most common GI cancer?

A

-Colorectal

45
Q

What are the two types of oesophageal cancer?

A
  • Squamous cell

- Adenocarcinoma

GI (16 decks)

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