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Gastric Tumors SMS 2044
GASTRIC CANCER ,[object Object],[object Object],[object Object],Contn…
Gastric  Cancer  Epidemiology  Forth common types of cancer Second most common  cancer related death   Geographic  variations  (ten times) Continuing  decline   Primarily a decline  of distal GC   (2000) (2000)
TUMORS ,[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object]
Gastric  Cancer   Environmental factors H. pylori Genetic factors Etiological Factors of Gastric Cancer Precancerous changes
TYPES OF GASTRIC CANCER: ,[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],MORPHOLOGY
08/19/11 Free template from www.brainybetty.com
Histoology ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
08/19/11 Free template from www.brainybetty.com
08/19/11 Free template from www.brainybetty.com
PATHOLOGY OF GASTRIC (MALIGNANT)    TUMOURS: ,[object Object]
   Types   of   Malignant   Tumours : ,[object Object],[object Object],[object Object],[object Object]
Pathohistologic classification   Histology Adenocarcinoma  90% Lymphoma  5% Stromal  2% Carcinoid  <1% Metastasis  <1% Adenosquamous/squamous  <1% Miscellaneous  <1%
[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],   The macroscopic forms of gastric cancers are  classified by (Bormann classification) into:-
08/19/11 Free template from www.brainybetty.com
08/19/11 Free template from www.brainybetty.com
Carcinoma of the stomach Free powerpoint template: www.brainybetty.com
Pathogenesis ,[object Object],[object Object],[object Object]
Pathogenesis ,[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],MORPHOLOGY
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
08/19/11 Free template from www.brainybetty.com
[object Object],[object Object],The three macroscopic growth patterns of gastric carcinoma, which may be evident at both the early and advanced stages, are  (1)  Exophytic,   with protrusion of a tumor mass into the lumen;  (2)  flat or depressed,   in which there is no obvious tumor mass within the mucosa; and (3)  Excavated,   whereby a shallow or deeply erosive crater is present in the wall of the stomach.
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
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Free powerpoint template: www.brainybetty.com
[object Object],[object Object],[object Object],Histologic appearances
Microscopy ,[object Object],[object Object]
Histopathology ,[object Object],[object Object],[object Object],[object Object],[object Object]
Histopathology ,[object Object],[object Object],[object Object],[object Object],08/19/11
08/19/11 Gastric adenocarcinoma is a malignant epithelial tumor, originating from glandular epithelium of the gastric mucosa.  According to Lauren classification, gastric adenocarcinoma may be: intestinal type, diffuse type and mixed type
[object Object],[object Object],[object Object],08/19/11 Free template from www.brainybetty.com
Gastric cancer.  A,  Intestinal type demonstrating gland formation by malignant cells, which are invading the muscular wall of the stomach. (H & E.)  B,  Diffuse type demonstrating individual red, mucin-containing malignant cells in the lamina propria of an intact mucosa. (Mucicarmine stain.)
08/19/11 Free template from www.brainybetty.com
Gastric Carcinoma Malignant Normal Gland
Stages  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Morphology---early stage
Morphology---early stage
Morphology---early stage
Morphology ---advanced stage
[object Object]
[object Object]
[object Object],[object Object],[object Object],[object Object],Clinical Features
Clinical manifestation Signs and Symptoms Early Gastric Cancer Asymptomatic or silent  80% Peptic ulcer symptoms  10% Nausea or vomiting  8% Anorexia  8% Early satiety  5% Abdominal pain  2% Gastrointestinal blood loss  <2% Weight loss  <2% Dysphagia   <1%
Signs and Symptoms Advanced  Gastric Cancer Weight loss  60% Abdominal pain  50% Nausea or vomiting  30% Anorexia  30% Dysphagia  25% Gastrointestinal blood loss  20% Early satiety  20% Peptic ulcer symptoms  20% Abdominal mass or fullness  5% Asymptomatic or silent  <5% Duration of symptoms Less than 3 month  40% 3-12 months  40% Longer than 12 month  20%
[object Object],[object Object],[object Object],[object Object]
Spread of gastric carcinoma ,[object Object],[object Object],[object Object],[object Object]
Less common gastric neoplasms ,[object Object],[object Object],[object Object]
Gastric lymphoma ,[object Object],[object Object]
Gastric lymphoma (maltoma) ,[object Object],[object Object]
Gastrointestinal stromal tumours (GIST) ,[object Object],[object Object],[object Object],[object Object],[object Object]
GIST-spindle cell neoplasm of GI tract
GIST ,[object Object],[object Object]
Neuroendocrine tumours ,[object Object],[object Object],[object Object]
INVESTIGATIONS : ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Treatment  Surgical resection EMR = Endoscopic mucosal resection Adjuvant therapy Palliative therapy
TREATMENTS   OF   GASTRIC   CANCER: ,[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object]
08/19/11 Alamak, Finish

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Lect 4-gastric tumors

Notes de l'éditeur

  1. This regional difference has been attributed to environmental factors. There is a continuing worldwide decline in prevalence and death rate. The reduction in the incidence of gastric carcinoma may reflect primarily a decline in carcinomas of the distal stomach.
  2. The development of gastric cancer is a multi-factor process. A large number of risk factors have been associated with gastric cancer. These include dietary factor, smoking, H. pylori infection, low gastric acidity, genetic factors. Excessive intake of salt or salty food, low consumption of fresh fruits and vegetables are likely contribute to the development of gastric cancer. Studies had indicated there was a significant association between cigarette smoking and gastric cancer risk, particularly in male smokers. H. pylori is a definite carcinogen accounting for at least 300 000 new cases of gastric cancer each year worldwide. Familiar studies have found that the risk of developing gastric cancer for relatives of cases is increased two- to three-fold suggesting a role of genetic factors. Low gastric acidity may increase intraluminal formation of N-nitroso compounds which are carcinogens.