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Flashcards in Gastric Tumours Deck (28)
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1

what are the benign gastric tumours? 2

hyperplastic polyps
cystic fundic gland polyps

2

what are the malignant tumours of the stomach? 3

carcinomas (most are adenocarcinomas unsurprisingly)

lymphomas

gastrointestinal stromal tumours (GIST) - distinct group of mesenchymal tumours

3

In the UK proximal adenocarcinoma tumours of the cardia/GOJ are ____ and distal tumours are _____

In the UK proximal tumours of the cardia/GOJ are increasing and distal tumours are decreasing

4

what are the two major histological types of adenocarcinoma?

intestinal and diffuse

5

intestinal : ____ /____ mass

diffuse: ___ /____ stomach wall

Intestinal : exophytic/polypoid mass- this is more resectable. These are well formed glandular structures

Diffuse: expands/infiltrates stomach wall

6

benign peptic ulcers ___ adenocarcinoma but they are more ___ __ and lack a ___ ___ ___

mimic, punched out and lack a raised rolled edge

7

what is the aetiology of adenocarcinoma? 5

H Pylori infection important

other premalignant conditions
- pernicious anaemia
- partial gastrectomy
- HNPCC/lynch syndrome
- menetrier's disease

8

how do adenocarcinomas spread? 3

local spread into other organs

lymph nodes

haematogenous

9

what is an important site for local invasion?

ovaries - kruckenburg syndrome

10

what is the node that is a sign of gastric cancer?

virchows node - left clavicular

11

why is early liver metastases common?

the venous drainage from the stomach is straight to the liver

12

what is gastric lymphoma derived from?

the mucosa associated lymphoid tissue

13

lymphoma is associated with _____ infection

H.Pylori

14

lymphoma involves continuous ______ which induces an evolution into a ___ ___ cell- proliferation - this is a __ grade lymphoma
If left unchecked it evolves into a ___ grade lymphoma

It involves continuous inflammation which induces an evolution into a clonal B cell- proliferation - this is a low grade lymphoma
If left unchecked it evolves into a high grade lymphoma

15

where is the commonest site for lymphoma in the GI tract and why?

The stomach is the commonest site for lymphoma in the GI tract because of the large amount of lymphoid tissue

16

what does lymphoma look like histologically ?

small round lymphoid cells

17

most people that have lymphoma will be ______

asymptomatic

18

what are the signs of gastric cancer?

- Abdominal mass
- Jaundice
- Paraneoplastic syndrome
- Weight loss

19

what are the symptoms?

dyspepsia - abdominal pain, emesis, anorexia, dysphagia, early satiety

upper GI haemorrhage

20

what is picked up on physical examination?

weight loss, lymph nodes - large virchow's, abdominal masses

21

how is it diagnosed?

upper GI endoscopy and biopsy

22

what imaging techniques are done

barium meal

- CT (MRI) scan

23

what are the treatment options?

surgery

radiotherapy

chemotherapy

24

surgery

For palliation of symptoms and for improved survival
Abdominal operation
Can remove involved adjacent organs

25

what are the contraindications of surgery? 3

- Widely metastatic disease
- Malignant ascites
- Brief life expectancy

26

surgery
- ____- gastrectomy for proximal lesions
- ___ gastrectomy for distal lesions

Total gastrectomy for proximal lesions
Partial gastrectomy for distal lesions

27

when is chemotherapy done?

in advanced and metastatic disease

28

what are the adverse prognostic factors for gastric cancer? 6

- Metastatic disease
- Short history
- Advanced age
- Proximal lesion
- Locally advanced lesion
- Superficial gross appearance