Carcinoid, GI Stromal Tumor and Lymphoma Flashcards
What is the pathophysiology of gastric carcinoid tumors?
chronic gastritis or gastric acid suppression leads to hypergastrinemia compensatory response. this leads to gastric diffuse neuroendocrine hyperplasia and then to tumors.
WHat on histology may the neuroendocrine tumor look like
sheets nests trabeculae whatever it wants
What is the immunostain for neuroendorcrine tumores?
chromogranin and synaptophysin
What the the dx criteria for ZE syndrome
fasting gastrin level about 1000 pg/ml with gastric ph below 5
secretin stumulation test with increase in gastin of more than 200 pg/ml
How do you tx ZE
surgery and high dose ppi
Where do you common see intestinal neuroendocrine tumors? In what age?
ileum and appendix, common in late middle age
what is carcinoid syndrome?
episodes of flushing, diarrhea, wheezing, colicky abd pain
right heart endocardial fibrosis
what is responsible for the efx of carcinoid syndrome
vasoactive polypeptides, serotonin
what is diagnostic test for carcinoid syndrome?
5-HIAA
what will immunostain c-kit cd117 mean
it can be treated with imatinib
where are GI stromal tumors most common?
in the stomach and small intestine
what is the common mutation in GISTs?
kit transmembrane receptor tyrosine kinase, activating it as an oncogene with positive immunostain for cd117
GIST presents with what sorts of things?
overt GI bleeding, abdominal mass or abd pain
Gastrointestinal lymphoma is associated with what/
h pylori
Ai dz
immunodificiency
celiac dz
how do gastrointestinal lymphomas present?
epigastric pain!!!!! anorexia weight loss occult bleeding n/v
