klara matijević mentor: a. Žmegač horvat. adenocarcinoma gastrointestinal stromal tumours...
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Klara MatijevićMentor: A. Žmegač Horvat
adenocarcinoma gastrointestinal stromal tumours
(GIST)
primary gastric lymphoma
gastric polyps
4th most common cancer world-wide 2nd leading cause of cancer-related
mortality incidence increases with age (rare under
the age of 30) highest incidence: Eastern Asia (Japan),
Eastern Europe, South America men:women = 2:1
H.pylori infection (group 1 gastric carcinogen)
dietary factors smoking tobacco genetic abnormalities increased risk after partial gastrectomy
Diagram showing the development of gastric cancer associated with H.pylori infection
Lauren classification: • intestinal type
• diffuse type
• diffuse carcinoma of linitis plastica type
• gastric adenocarcinoma of intestinal type
Borrmann classification:• polypoid• ulcerating• ulceroinfiltrative• infiltrative
• gastric adenocarcinoma of polypoid type
• gastric adenocarcinoma of ulcerative type
TNM classification:
.
Stage 0 Tis N0 M0
Stage IA T1 N0 M0
Stage IB T1 N1 M0
T2a/b N0 M0
Stage II T1 N2 M0
T2a/b N1 M0
T3 N0 M0
Stage IIIA T2a/b N2 M0
T3 N1 M0
T4 N0 M0
Stage IIIB T3 N2 M0
Stage IV T4 N1–3 M0
T1–3 N3 M0
Any T Any N M1
Stage Grouping
advanced disease at the time of presentation
symptoms at early stage: fullness in upper abdomen,
nausea, anorexia advanced disease
symptoms: epigastric pain, nausea,
vomiting, dysphagia weight loss anemia (because of bleeding) palpable lymph node –
supraclavicular fossa (Virchow’s node)
1. patient history + physical examination
non-specific findings
2. lab findings FBC + LFT
3. barium meal4. ENDOSCOPY (EGD) !!!5. staging:
chest X-ray abdominal US CT scan
endoscopic removal (only early non-ulcerated mucosal lesions)
surgery chemotherapy radiotherapy palliative care
GI mesenchymal tumors asymptomatic, found by chance
(ulceration, bleeding) treatment:
surgery chemotherapy if unresectable
benign rarely produce symptoms types:
hyperplastic adenomatous cystic gland polyps inflammatory fibroid polyps
treatment : endoscopic excision
Kumar and Clark: Clinical Medicine (7th edition)
B.Vrhovac, B.Jakšić, Ž.Reiner, B.Vucelić: Interna medicina
www.pathconsultddx.com