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