B5-071 GI Cancers: Tubal Gut Flashcards
(90 cards)
1
Q
- distal/lower esophagus
- arises from Barrett’s
A
esophageal adenocarcinoma
2
Q
- mid esophagus
- not associated with Barretts
A
esophageal squamous cell carcinoma
3
Q
in adenocarcinoma, columnar epithelium is replaced with […] cells
A
goblet
4
Q
treatment of Barrett’s
A
no/low dysplasia: increased surveillance
high dysplasia: ablation
5
Q
risk factors for esophageal adenocarcinoma
5
A
- GERD
- obesity
- male sex
- smoking
- H. pylori
6
Q
- long standing GERD
- dysphagia
- weight loss, pain, vomiting
A
esophageal adenocarcinoma
7
Q
flat/slightly raised lesion early
ulcerated mass later on
A
esophageal adenocarcinoma
8
Q
- gland formation and mucus production
- may have signet ring formation
A
esophageal adenocarcinoma
9
Q
genes associated with esophageal adenocarcinoma
A
- p53, CDKN2A, APC inactivation
- ERBB2/HER2 amplification
10
Q
risk factors for squamous cell carcinoma
5
A
- low SES
- tobacco
- alcohol consumption
- drinking hot beverages
- diet
11
Q
- dysphagia, odynophagia, obstruction
- weight loss
A
esophageal squamous cell carcinoma
12
Q
- mass-like lesion, may protrude into lumen, ulcerate
- may infiltrate and cause diffuse thickening
A
esophageal squamous cell carcinoma
13
Q
- malignant squamous epithelium invading into submucosa or deeper
- variably sized nests of epithelial tumor cells, ample eosinophilic cytoplasm, keratinization
A
esophageal squamous cell carcinoma
14
Q
risk factors for gastric adenocarcinoma
4
A
- H. pylori
- rubber manufacturing
- tobacco
- radiation
15
Q
- often asymptomatic or have dyspepsia, dysphagia, nausea
- weight loss, anorexia, early satiety at later stages
- metastasis often present at diagnosis
A
gastric adenocarcinoma
16
Q
which type of gastric adenocarcinoma is associated with WNT mutations?
A
intestinal
17
Q
which type of gastric adenocarcinoma is associated with CHH1 mutations?
A
diffuse
associated lobular breast cancer as well
18
Q
which type of gastric adenocarcinoma is comprised of infiltrating malignant glands with mucin production?
A
intestinal
19
Q
which type of gastric adenocarcinoma is associated with sheets of cells and diffuse thickening?
A
diffuse
20
Q
elevated mass with central ulceration
A
intestinal type gastric adenocarcinoma
21
Q
infiltrating and anastomosing glands with various degrees of differentiation
A
intestinal type gastric adenocarcinoma
22
Q
- gastric wall markedly thick, rugal folds lost
- stomach may appear shrunken
A
diffuse type gastric adenocarcinoma
23
Q
- signet ring cells
- sheets of cells
A
diffuse type gastric adenocarcinoma
24
Q
most common type of gastric lymphoma
A
MALT lymphoma
25
major risk factor for gastric lymphoma
H. pylori
26
* often asymptomatic
* may present with dyspepsia, epigastric pain, hematememsis, melena
gastric lymphoma
27
* thickening of the wall of stomach
* nodular mucosa
gastric lymphoma
| MALT
28
* diffuse sheets of lymphocytes
* lymphocytes in the glandular epithelium
* comprised of B lymphocytes positive for CD20
gastric lymphoma
| MALT
29
comprised of B lymphocytes positive for CD20
gastric lymphoma
| MALT
30
well differentiated epithelial neoplasms with neuroendocrine differentiation
NET
31
risk factors for gastric NET
| 2
MEN-1
AMAG
32
acid hypersecretion/peptic ulceration secondary to high gastrin levels from duodenal/pancreatic gastrinomas
Zollinger-Ellison syndrome
33
symptoms of carcinoid syndrome
flushing, bronchospasm, diarrhea
| maybe sweating and abdominal pain as well
34
may present with Zollinger-Ellison or carcinoid syndromes
gastric NET
35
# what type of gastric NET?
* arise in AMAG
* high gastrin
* 75% of GNETs
* good prognosis
type 1
36
# what type of gastric NET?
* associated with MEN-1
* high gastrin
* zollinger ellison
* 5-10% of GNETs
* moderate prognosis
type 2
37
# what type of gastric NET?
* sporadic GNETs
* normal gastrin levels
* 15% of GNETs
* poor prognosis
type 3
38
mass like lesion/nodule
GNET
39
* may have nests, trabeulae, or be solid
* cells are uniform, moderate cytoplasm
* stipple "salt and pepper" chromatin
GNET
40
* may have nests, trabeulae, or be solid
* cells are uniform, moderate cytoplasm
* stipple "salt and pepper" chromatin
GNET
41
* most commonly mesenchymal tumor of the abdomen
* arise from interstitial cells of Cajal within muscularis propria
GIST
42
risk factor for GIST
NF1
43
* asymptomatic when small
* symptomatic when large, may ulcerate causing bleeding
GIST
44
genetic associations with GIST
* **activating mutation in KIT** (80%)
* activating mutation in PDGFRA
| can use imatinib
45
* solid, well circumscribed mass with pink-tan fleshy cut surfaces in the wall of stomach
* centered on muscularis propria but may involve muscosa
GIST
46
* spindled cells or epithelioid cells
* IHC positive for KIT and DOG1
GIST
47
second leading cause of cancer deaths
colorectal cancer
48
* most common GI cancer
* incidence peak 60-70 y.o.
* incidence under 40 increasing
colonic adenocarcinoma
49
risk factors for colonic adenocarcinoma
| 5
* diet (red meat, low fiber)
* alcohol
* obesity
* genetics
* IBD
50
protective factors against colon cancer
* increased physical activity
* hormone replacement therapy in women
51
advanced left sided colon cancer may present with
change in bowel habits, abdominal distension, hematochezia, obstruction
52
advanced right sided colon cancer may present with
fatigue, weight loss, anemia
53
colonoscopy screenings begin at age
45
| earlier if family hx
54
which pathway of genetic stability affects a small number of genes
APC
| chromosomal instability
55
which pathway of genomic instability affects a large number of genes?
MSI
| microsatellite instability
56
precursor lesion in the APC/WNT pathway
adenoma
57
adenoma
| APC/WNT pathway
58
FAP is inherited in a [...] pattern
autosomal dominant
59
FAP is caused by mutations in the [...] gene
APC
| key regulator of the WNT pathway
60
how many polyps are necessary for FAP?
at least 100
61
FAP
62
mutations associated with Lynch syndrome
**MSH2 and MLH1**
also PMS2 and MSH6
| mismatch repair genes
63
no substantial malignant potential and do not affect colonoscopic surveillance intervals
hyperplastic polyp
64
* precursor to adenocarcinoma
* serrated polyp with widened base
sessile serrated polyp
65
* often exophytic mass
* may present as diffuse, circumfrential thickening
colon-adenocarcinoma
66
* invasive malignant glands extending into submucosa or deeper
* often has central necrosis
* may have no glands or signet features
colon adenocarcinoma
67
FAP results from inheritance of one mutant copy of
APC
68
genes affected in HNPCC
mistmatch repair
* MLH1
* MSH2
* MSH6
* PMS2
69
NOD52 mutations are linked with
Crohn's
70
in FAP, polyps form when
the second copy of APC is lost due to additional mutations
| two hit hypothesis
71
the cells of origin of GIST
intersitial cells of Cajal
72
neuroendocrine tumors arise from
G cells
73
adenocarcinomas arise from
gastric epithelial cells
74
leiomyomas arise from
smooth muscle cells of muscularis propria
75
HNPCC is associated with an increased risk of what cancers
| 2
colon
endometrial
76
homozygous loss of the DNA mismatch repair genes can give rise to
right sided colon cancer
endometrial cancer
77
associated with microsatellite instability
HNPCC
78
associated with beta catenin pathway
FAP
79
loss of CDH1 gene is associated with
hereditary gastric carcinoma
80
mutation with activation of c-kit tyrosine kinase activity is associated with
gastrointestinal stromal tumors
81
treatment for gastrointestinal stromal tumors
imatinib
82
develops at the site of long-standing GERD
barrett's
83
adenocarcinomas of the esophagus are typically located in the
distal esophagus
84
squamous cells carcinomas of the esophagus are typically located in the
mid esophagus
85
squamous cells carcinomas are associated with what risk factors
chronic alcoholism
smoking
86
major risk factor for adenocarcinoma
Barrett's esophagus
87
intranuclear inclusions
CMV or HSV esophagitis
88
precursor lesion to invasive adenocarcinomas
adenomas
89
* typically small and yellowish
* slow growing
carcinoid tumors
90
squamous cell carcinomas can arise where?
| 2
esophagus
anal-rectal junction
