Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

GIR Test 4 > B5.071 - GI Tubal Cancers COPY > Flashcards

B5.071 - GI Tubal Cancers COPY Flashcards

(107 cards)

Start Studying
1
Q

describe adenocarcinoma in the esophagus

A

distal esophagus

arises from Barretts

more common than squamous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

types of cancer in the stomach

A

adenocarcinoma (most common)

lymphoma (H. plyori)

neuroendocrine (MEN1)

gastrointestinal stromal tumor (GIST)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q
A

villous adenoma of colon with long sleder projections that are reminiscent of small intestinal villi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

microscopic appearance of esoph squamou cell carcinoma

A

dysplastic/atypical squamous epithelium invading into submucosa or deeper

variably sized nests of tumor cells with epithelioid cells, ample eisinophilic cytoplasm, keratinization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

describe lynch syndrome

A

pts do no have multiple polyps

often cancer at earlier age

follows microsattelite instablle pathway

germline mutations in mismatch repair proteins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

precursor lesion for squamousc cell carcinoma of esophagus

A

squamous dysplasia, plaque like thickening

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q
A

dysplasia in barretts esophagus

abrupt transition from barrett metaplasia to low grade dysplasia

note nuclear stratification and hyperchromasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

risk factors for carcinoid tumor

A

MEN-1, AMAG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

presentation of GIST

A

asymptomatic

sx due to mass effect when large, may ulcerate causing bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

diffuse type stomach adenocarcinoma features

A

gross: diffues thickening (linitis platsica)
micro: sheets of cells sometimes signet ring

associated with hereditary gastric cx

mutations in CDH1 (e-cadherin)

pts also have lobular breast cx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

describe squamous cancer of esophagus

A

middle/upper esophagus

not assoicated with barretts

more common world wide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

location of esophageal adenocarcinoma

A

distal 1/3 of esophagus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

presentation of esophageal adenocarcinoma

A

long standing GERD
odynophagia or dysphagia

weight loss, vomiting. hematemesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

location and clinical presentation of squamous cell carcinoma of esophagus

A

mid esophagus or upper

dysphagia, odynophagia, obstruction

weight loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what is a hyperplastic polyp

A

not considered a precursor to adenocarcinoma

microscopic shows serrated polyp without dilation at the base

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q
A

neuroendocrine tumor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

molecular features of GIST

A

most have activating mutation in KIT gene

some have activating mutation in PDGFRA

treatment with imatinib only works in tumors with mutations in these genes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

risk factors for esoph squamous cell carcinoma

A

smoking, alcohol, esophageal injury, achalasia, frequent consumption of very hot beverages, radiation, lower SES

more common in iran, china, brazil, SA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

pathogenesis of colon adenocarcinoma (2 pathways)

A

stepwise collection of multiple mutations

APD/beta catenin pathway

microsattelite instable pathway

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q
A

GIST

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q
A

barrett

architectural irregularities, including gland within glad or “cribiform” profiles in high grade dysplasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

risk factors for lymphoma

A

chronic inflammation, H. pylori (eradication of H pylori can resolve lymphoma in early stage)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

intestinal type stomach adenocarcinoma features

A

gross: mass lesion, often ulcerated
micro: intiltrating atypical glands with mucin production

associated with intestinal metaplasia, FAP, H. pylori

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

describe barretts esophagus

A

replacement with columnar epithelium and goblet cells

resonse to repeated injury of reflux (10% of pts with GERD)

may develop dysplasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
what do you do for barretts with high grade dysplasia
surveillance if single focus laser ablation, endoscopic resection
26
risk factor for GIST
NF1
27
treatment for esoph. squamous cell carcinoma
chemo/radiation surgery
28
high grade dysplasia dysplastic cells extend to surface of the epithelium and are associated with significant loss of surface maturation squamous cell carcinoma of esophagus
29
GIST
30
molecular alterations of stomach adenocarcinoma
mutation of TP53 may displat MSI ERBB2 (HER2) in intestinal type CDH1 lost in most diffuse type cancers
31
tubular adenoma smooth surface rounded glands
32
important hereditary considerations for colon adenocarcinoma
FAP - germline APC considerations Lynch syndrome (HNPCC, hereditary non polyposis colorectal cancer)
33
describe FAP
many polyps which are tubular adenomas follows traditional APC pathway often have cancer at early age
34
treatment of neuroendocrine tumor and prognosis
resection prognosis - good cured after resection, sporadic may be more aggresseive
35
presentation of carcinoid tumor
if functional - zollinger ellison syndrome carcinoid syndrome - cutaneous flushing, bronchospasm, sweating, abdominal pain, diarrhea
36
presentation of colon adenocarcinoma
no signs/sx early advanced on left side - change in bowel habits abdominal distention, hematochezia (if ulcerates) right side - fatigue, weight loss, anemia
37
describe the microsattelite instable pathway in colon adenocarcinoma
deficiency in mismatch repair proteins precursor lesion often the sessile serrate adenoma do not respond well to traditional chemo more commonly right sided
38
what is GIST
most common mesenchymal tumor of the abdomen more than 1/2 arise in stomach arise from interstitial cells of cajal within muscularis propria
39
gross appearance of esoph squamous cell carcinoma
mass like lesion, may protrude into lumen, ulcerate may infiltrate and cause diffsue thickening
40
risk factors for esophageal adenocarcinoma
GERD, obesity, tobacco, alcohol, radiation
41
intestinal type stomach adenocarcinoma
42
treatment of GIST
resection imatinib for unresectable, metastatic or recurrent that has KIT or PDGFRA mutations
43
MALT lymphoma lymphoepithelial lesions with neoplastic lymphocytes surrounding and infiltrating gastric glands
44
what is considered a sporadic NE tumor
not associated with AMAG or MEN-1
45
types of cancers in the esophagus
adenocarcinoma squamous carcinoma
46
describe the APC/beat catenin pathway
classic adenoma --\> carcinoma sequence precursor lesion often the **tubular adenoma** more commonly left sided
47
esoph. squamous cell carcinoma well differentiated, with keratin production
48
treatment for esophageal adenocarcinoma
chemo/radiation surgical resection (esophagectomy)
49
important mutations in colon adenocarcinoma
KRAS NRAS BRAF if mutated, less/no response to anti EGFR therapies like cetuximab
50
intestinal type adenocarcinoma note: infiltrating glands with various degrees of differentiation
51
what is sessile serrated adenoma
prescursor to adenocarcinoma, via the microsattelite instable pathway micro shows serrated polyp with widened base no cytologic atypia --\> low garde atypia --\> high grade atypia --\> carcinoma lesions without atypia though to have similar chance to progress as tubular adenoma; increased risk with cytologic atypia
52
tx of stomach lymphoma
treat h pylori chemo
53
esophageal adenoarcinoma glands organized into back to back glands and mucin production
54
what is AMAG
antibodies to parietal cells
55
features of colon adenocarcinoma
3rd most common behind prostate and lung in men behind lung and breast in women
56
prognosis for esophageal adenocarcinoma
early has good prognosis (80% at 5 years) late - less than 25% survivial at 5 years
57
treatment of stomach adenocarcinoma
resection chemo trastuzumab in HER2 overexpression
58
diffuse type stomach adenocarcinoma
59
neuroendocrine tumor
60
signet ring carcinoma esoph adenocarcinoma
61
prognosis for esoph. squamous cell carcinoma
early - 75% late - 20%
62
risk factors for colon adenocarcinoma
physical inactivity obesity red meat/smoking/alcohol high veggies decreases risk
63
GIST epithelioid type, arranged in broad sheets with occasional multinucelated cells
64
what is a precursor lesion to adenocarcinoma
barretts esophagus
65
barretts esophagus
66
what do you do for barretts with low grade dysplasia
increased surveillance
67
presentation/sx of stomach lymphoma
dyspepsia, epigastric pain, hematemesis, melena
68
esoph. squamous cell carcinoma dysplastic cells with increased nucelus to cytoplasm ration marked hyperchromatic nuclei, significant los of polarity and overlapping of cells and nuclei
69
gross appearance of esoph. adenocarcinoma
flat/slightly raised lesion early to large, ulcerated mass later often barretts mucosa around mass
70
MALT lymphoma
71
microscopic appearance of esph. adenocarcinoma
gland formation, mucin production may have slight ring formation
72
what do you do for barretts esophagus (goblet cells, no dysplasia)
surveillance biopsies
73
low grade squamous dysplasia characterized by proliferation of neoplastic cells involving about 1/3 - 1/2 of thickness of epithelium
74
GIST note spindle cell type, typical prominent perinuclear vacuoles
75
gross/histo of neuroendocrine tumors
gross - mass like lesion or nodule histo - similar to pancreatic NE tumor, nests, trabeculae (cords), solid cells are uniform, moderate cytoplasm, stippled or salt and pepper chromatin
76
esophageal adenocarcinoma
77
protective factors for esophageal adenocarcinoma
diets rich in fruits/veggies H. pylori infx (causes atrophy of stomach, decreased acid secretion) M\>F 7:1
78
esph. squamous cell carcinoma poorly differentiated, keratin production
79
risk factors for stomach adenocarcinoma
chronic gastritis (incluidng H. pylori) inherited disorders (FAP, hereditary diffuse gastric cx) more common in japan, chle, costa rica, eastern europe
80
presentation of stomach adenocarcinoma and prescursor lesion
often asymptomatic, vague sx dyspepsia, dysphagia, nausea metastatis often present at time of dx precursor lesion intestinal metaplaisa, gastric adenoma/dysplasia
81
gross and microscopic appearance of stomach lymphoma
gross - thickening of wall of stomach, nodular mucosa micro - diffuse sheets of lymphocytes, infiltrate the glandular epithelium, comprised of B lymphocytes (+CD20)
82
gross appearance of GIST
`solid, well circumscribed mass with pink-tan fleshy cut surfaces in the wall of the stomach centered on muscularis propria, but may extend to involve mucosa
83
lymphomas
extranodal lymphomas can occur anywhere GI tract is common site (including stomach) primary gastric lymphomas are 5% of gastiric malignancy most are marginal zone B cell lymphoma (MALTomas, mucosa associated lymphoid tissue)
84
what is a tubular adenoma
precursor to adenocarcinoma via the APC/beta catenin classical pathway by definition has low grade dysplasia microscopic shows tubular architecture with lowe grade dysplasia/cytologic atypia low grade --\> high grade --\> invasive carcinoma
85
histo of barretts esophagus note transition between esophageal squamous mucosa (L) and barrett metaplasia with abundant metplastic goblet cells
86
esoph. squamous cell carcinoma
87
diffuse type stomach adenocarcinoma note - prominent intracytoplasmic mucin dorplet with enlarged, eccentrically located, flattened nucleus
88
normal gastroesophageal junction
89
surveillance for colon adenocarcinoma
starts at 50, earlier if family hx precursor lesion - adenomas screening every 10 years, more if precursor found
90
micro appearance of GIST
spindled cells more common, epithelioid also possible immunohistochemical stains for KIT and DOG1 usually positive
91
prognosis for GIST
depends on location, size and mitotic activity of GIST
92
molecular alterations in esoph adenocarcinoma
start in barretts early: p53, p16, APC inactivation later: ERBB2/**HER2** **HER2 can be targeted by trastuzumab**
93
dysplastic epithelia cells with increased nuc:cytoplasm ratio hyperchromatic and elongated nuceli and nucelar pseudostrarification
94
sessile srrated adenoma lined by goblet cells without cytologic features of dysplaisa extesnison of neoplastic process to crypts resulting in lateral growth. diff from hyperplastic polyp bc of the widened base
95
tubular adenoma in colon
96
tubular adenoma colon
97
hyperplastic polyp poly surface with irregular tufting of epithelial cells
98
hyperplastic polyp
99
hyperplastic polyp
100
gross apearance of colon adenocarcinoma
often exophytic mass may be present as diffues, circumferential thickening
101
micro appearanc of colon adenocarcinoma
gland formation, mucin production invasive islands of atypical glands often has central necrosis may have poorly differentiated or signet ring features
102
colorectal adenocarcinoma ulcerted rectal cancer (r) cancer of sigmoid colon invading thru muscularis propria areas of chalky necrosis are present within colon (L)
103
colon adenocarcinoma some necrotic debris noted
104
colon adenocarcinoma few glands with nests of tumor cells
105
colon adenocarcinoma
106
colon adenocarcinoma treatment
resection possible chemo 5-FU for non MSS cetuximab (anti EGFR) for tumors without KRAS/NRAS/BRAF
107
prognosis of adenocarcinoma of colon
based on stage overall 5 yr is 65%

GIR Test 4 (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions