Flashcards in 35. Stomach cancer Deck (25)
gastric cancers - types ( and MC)
1. adenocarcinoma ( mC)
3. GI stromal tumor
4. carcinoid ( rate)
gastric cancer - behaviour , anemia
early aggresive local spread with node/ liver metastasis ---> oFTEN PRESENTS LATE
gastric cancer symptoms ( not signs)
present late, weight loss, early satiety
gastric cancer - signs
1. Leser Trelat sign
2. Virchow node
3. Krunkeberg tumor
4. Sister Mary Joseph nodule
5. acanthosis nigricans
Leser Trelat sign
explosive onset of multiple seborrheic keratosis
gastric cancer - Virchow node
involvement of left supravalvicular node by metastasis from stomach
bilateral metastases to ovaries . Abundant mucin - secreting , signet ring cells
Sister Mary Joseph nodule
subcutaneous periumbilical metastasis
gastric adenocarcinoma - subtypes
gastric adenocarcinoma - interstinal vs diffuse according to H.pylori
1. intestinal ---> associated
2. diffuse --> not associated
gastric adenocarcinoma - causes of intestinal
2. dietery nitrosamines (smoked foods )
3. tobacco smoking
5. chronic gastritis (intestinal metaplasia )
6. blood type A
gastric adenocarcinoma - apperance / location
looks like ulcer with raised margins commonly on lesser curvature
gastric adenocarcinoma - diffuse type - histological and gross apperance
signet ring cells (mucin filled cells with peripheral nuclei ) stomach wall grossly thickened (linnitis plastica ) due to desmoplasia
signet ring cells - apperance
mucin filled cells with peripheral nuclei
• What is the most common histologic subtype of stomach cancer?
• Where are intestinal stomach cancers most commonly located in the stomach: lesser curvature, greater curvature, fundus, or cardiac region?
• A patient with stomach cancer is at risk of metastasis to what organ?
The liver (this is the next downstream organ)
• Name at least three risk factors for stomach cancer.
Nitrosamines (from smoked foods), achlorhydria, chronic gastritis, smoking, H. pylori (the intestinal kind) infection
• What is meant when stomach cancer is termed linitis plastica?
Diffuse infiltrative cancer makes the stomach rigid
• A man has 1 month of fatigue, weight loss, and early satiety. If he has palpable lymph nodes (from metastases), where are they likely found?
Left-sided supraventricular nodes (also called Virchow nodes) (metastasis from stomach cancer classically spreads to these nodes)
• A woman has bilateral ovarian cancer with abundant mucus & signet ring cells. Could this cancer in fact be a metastasis?
Yes, as this could represent metastasis from the stomach to both ovaries (Krukenberg tumor)
• A patient has dark leathery patches on the nape of his neck and in the axillae. It is from malignancy. What might you see on his umbilicus?
One may see Sister Mary Joseph nodules (subcutaneous periumbilical metastasis) (this is acanthosis nigricans, suggesting stomach cancer)
• What is the histologic appearance of the Krukenberg tumor?
Metastatic gastric adenocarcinoma often has mucus-filled cells termed signet ring cells
• What is the Sister Mary Joseph nodule, and where is it located?
It is a metastasis of gastric cancer located in the subcutaneous periumbilical area