Path GI neoplasia I esophagus & stomach Flashcards Preview

GI & Liver Fall 2013 CBD > Path GI neoplasia I esophagus & stomach > Flashcards

Flashcards in Path GI neoplasia I esophagus & stomach Deck (31):
1

5 factors associated with squamous cell carcinoma

EtOH
smoking
urban & lower SEC population
lye ingestion
red meat

2

3 adenocarcinoma of esophagus risk factors

2 rare ones

Barrett's esophagus
GERD
Truncal obesity

Rare: sclerdermerrrer, Zollinger Ellison syndrome

3

SCCA vs adenocarcinoma male or female?

4:1 SCCA
7:1 Adenocarcinoma

4

SCCA vs adenocarcinoma black or white?

black SCCA
white Adenocarcinoma

5

SCCA vs adenocarcinoma location?

middle SCCA
distal Adenocarcinoma

6

SCCA vs adenocarcinoma age?

65 SCCA
55 Adenocarcinoma

7

SCCA vs adenocarcinoma risk factors?

EtOH, smoking SCCA
Barrett's Adenocarcinoma

8

barium swallow results for esophageal carcinoma

narrowing & irregularity

9

staging of esophageal cancer 2

CT of chest (mediastinal spread)
EUS (depth of penetration, lymph node mets=bad)

10

prognosis

bad. 55% unresectable. surg & XRT

5% 5-yr survival
37-3% 5ysurvival, depending on spread

11

hyperplastic gastric polyps description

3 causes

<1 cm cystic masses, sessile/pedunculated

H pylori, atrophic gastritis, chronic inflammation

12

epidemiology of gastric cancer

lower SEC
2:1 male:female
70s
declining incidence in US

13

Risk factors for gastric cancer (6)

chronic atrophic gastritis
pernicious anemia
prior gastric surgery
dietary nitrates
gastric polyps
H pylori (5x risk)

14

how nitrates cause gastric cancer

bacterial growth, nitrate reductase, nitrites, N-nitroso compound

15

Types of gastric neoplasia (2 major)

gastric lymphoma 24%
gastric adenocarcinoma 74.6%

16

symptoms in gastric cancer

weight loss 62%
abdominal pain 52%
nausea 34%
dysphagia 26%
melena 20%
early satiety 18%
ulcer-type pain 17%

17

virschow's node

left supraclavicular node, met of gastric ca

18

sister mary joseph node

periumbilical nodule, met of gastric ca

19

linitis plastic

diffuse, hard gastric carcinoma

agressive, 5%, bad

20

only chance for cure of gastric carcinoma

surgery. chemo may help after surg.

21

early mutation in esophageal SCCA

p53

(no K-RAS or APC in SCC of esophagus!)

22

location of SCCA of esophagus

early appearance
late appearance (years)

upper 20%
middle 50%
lower 30%

small gray-white plaque thickenings
protruding (60%), flat (15%), excavated (25%)

23

keratin pearls in SCCA of esophagus?

rarely

24

early mutation (1) and later (5) in esophageal adenocarcinoma or Barrett's epithelium?

p53 (early)

hypermethylation of p16/INK4a
RB
cERB-B2 (HER2)
Cyclin D1
Cyclin E

25

goblet cells in adenocarcinoma of esophagus?

gets rarer as more malignant/dysplastic

26

3 histology hallmarks of hyperplastic gastric polyps

excess of cells
inflammation
edema

27

dilated corpus (body) oxyntic type glands

fundic gland polyp

28

stratified columnar epithelium in edematous polyp

worst risk

29

signet ring cells

indicates diffuse type gastric adenocarcinoma. (also possible in any adenocarcinoma)

30

how does obesity lead to esophageal carcinoma?

fat > gerd > barrett's > dysplasia > p53 & others > adenocarcinoma

31

What do EtOH and tobacco lead to in esophagus?

SCCA