Flashcards in Patho of stomach and Small bowel  Deck (16):
General causes of acute gastritis
acute inflammation + injury due to:
Chem injury (bile, strong acids, bases)
- Path: can see destruction of mucosal surface and inflammation
Stress related mucosal disease/gastritis
- mediated by?
- why is it sig to know this disorder?
Morphologically resembles acute gastritis
Mediated by vasoconstriction/ischemia
- erosion and ulceration may be widespread
this occurs in 75% of critically ill patients
- trauma, shock, sepsis (stress ulcers)
- burns (curling ulcers)
- intracranial (cushings ulcers)
On a stain, what do you expect to see with H. pylori infxns?
Neutrophil infiltrates (areas with lots of bacteria)
Lymphocyte infiltrates (lymphoid follicle - inflammatory injury of the stomach)
- what is it?
- How can you test for it?
example of chronic gastritis
Corpus restricted chronic atrophic gastritis
Anti-parietal cell and anti-intrinsic factor antibodies
+/- pernicious anemia
Common in scandinavian and european descent
lymphocyte and plasma cell infiltrate in body of stomach
glandular atrophy (parietal cells destroyed by inflamm infiltrates)
intestinal metaplasia (change from gastric to intestinal phenotype)
- no neutrophils or organisms
Complications of peptic ulcer disease
peptic - acid mediated
ulcer - ulceration
of stomach and duodenum
Peptic ulcer disease appearance
mucosa hands over edge and ulcer has a clean base
Not ragged base, ulcer is punched out
Causes of PUD
All polyps are benign, however, some have the capacity to turn malignant. Which ones betch?
- Increased incidence of FAP
- helicobacter gastritis + gastritides
Which of the gastric polyps are the most common?
- rare progression to cancer
- assoc w/ Helicobacter + gastritides
Fundic gland polyp
Cystically dilated oxyntic gland
very rare progression to cancer
Sporadic (usually PPI assoc.)
- only of the gastric benign polyps not involving helicobacter
epithelial tumor derived from malignant transformation of gastric epithelium
associated with chronic gastritis (esp helicobacter) + diet
90% of all gastric tumors and is the 2nd most common fatal malignancy in the WORLD
Symptoms of gastric adenocarcinoma
dyspepsia (indigestion), dysphagia, nausea
weight loss, anorexia, early satiety, anemia
- for each one below, what type of cancer are they seen in?
Which signalling pathway?
Which gene mutation/methylation?
Amplification of which gene?
Wnt signalling pathway
- can occur with loss of APC (as in FAP)
- common in INTESTINAL type cancers
Loss of CDH1
- common in DIFFUSE type cancer
- familial gastric cancer
Amplification of Her2/neu
- minority of tumors (intestinal>diffuse)
Signet ring cell histo
Diffuse gastric adenocarcinoma ( loss of CDH1)
Most lymphomas are _____, which are _____.
They are associated with _____ and often driven by ____ infxn.
Many gastric lymphomas can be cured with ______
MALT, low grade B cell (→ high grade)
Chronic gastritis, Helicobacter infxn