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Where do most (95%) of hte Malignancues of the Stomach originate?
- originate in the surface glandular epithelial
- cells of the stomach (adenocarcinoma)
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What Classification do we used for Adenocarcinomas of the stomach?
- The Lauren Classification
- - Intesstinal
- - Diffuse
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What do you see in the Intestinal Type of Cancer?
- -non-Signet ring
- - associated with H. Pylori
- -Declining in incidence
- -Occurs predominately in gastric antrum/pylorus; lesser > greater curvature
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What do you see in the Diffuse type of Stomach cancer?
- •Increasing incidence
- -Signet rings
- •No association with H.pylori
- •Dismal 5-year survival, none to 1 or 2%
- • Occur throughout the stomach
- •Linits Plastica!
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how is gastric carcinoma classified?
What is Linitis Plastica?
By depth of invasion
- Linitis plastica is an extreme form of flat or depressed advanced gastric carcinoma.Linitis plastica
- means thickening of the stomach
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This is Gastric Carcinoma
See Heeped up Borders
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- Both are Gastric cancer.
- 1st-- See signet ring cells= Diffuse type
- 2nd-- see no signet rings just gland formation = Intestinal type
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- This is Gastric Cancer (Linitis Plastica type)
- It is a diffuse type= Signet rings and NOT H.Pylori associated.
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Name some other Gastric Tumors (LLMMN)
- •Lymphoma (MALT, B-cell)
- •Mesenchymal (GIST)
- •Neuroendocrine (Carcinoid)
- •Lipoma
- •Metastatic
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This is a Gastric MALT (B cell) Lymphoma
It may be H. Pylori associated
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What does GIST stand for?
Where does it arise from?
What # occur in the stomach?
Any markers?
What do you see histologically?
Are they aggressive?
Treat with?
- Gastrointestinal Stromal Tumor
- Intestinal cells of Cajal
- 2/3
- cKIT
- Spindle cell features
- Most are non-Aggressive and low malignant potential
- Gleevec
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 see this tumor arising from Muscilaris Propria of the gastric wall, what is it?
GIST tumor
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 This is a slide of a c KIT positive tumor. What is it?
GIST
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What cells do you see in:
Duodenum
Jejunum
Ileium
- - Broners glands (make Bicarb)
- - Heneth cells
- - Peyers patches
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 What are we looking at?
Thiss is a pic of the Small intestine
Note: Pilli and Goblet cells
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What are the Congenital Abnormalities in the small and large bowel?
- Atresia and stenosis
- Meckel Diverticulum
- Hirschsprung Disease (Congenital Aganglionic Megacolon)
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What is Meckel Diverticulum?
Where is it found?
is it a true Diverticulum? What does this mean?
are they Symptomatic?
- •Failure of involution of the vitelline duct
- •Antimesenteric, found in distal ileum, within 1 m. of ileocecal valve
- •True diverticulum, it contains all three layers of the bowel wall (mucosa, submucosa and muscularis propria)
- - Most are asymptomatic
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What is Hirshsprung Disease (MEGA COLON)?
What is always affected? What areas are usually affected?
Sex?genetic?
If the Mega colon perforates, it does this in the ______.
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•Portion of colon that lacks both Meissner submucosal and Auerbach myenteric plexuses (failed to migrate during divelopement)
- •Rectum is always affected. The Rectum and the sigmoid are usually affected.
- - Males are affected more
- - can be genetic
- -Cecum
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