Difference between revisions of "Stomach"

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==Gastric adenocarcinoma==
==Gastric adenocarcinoma==
===General===
===General===
Epidemiology:
*Associated with helicobacter infections.
*Prognosis is often poor as it is discovered at a late stage.
*Higher prevalence in countries in the far east (e.g. Japan) - thought to be environmental, e.g. diet.
Treatment:
*Surgical excision. 
**Proximal tumours may require a complete gastrectomy as the stomach is innervated from its proximal part.
====Classification====
*Two different classification schemes.
*Two different classification schemes.
**Lauren<ref name=pmid14320675>{{cite journal |author=LAUREN P |title=THE TWO HISTOLOGICAL MAIN TYPES OF GASTRIC CARCINOMA: DIFFUSE AND  SO-CALLED INTESTINAL-TYPE CARCINOMA. AN ATTEMPT AT A HISTO-CLINICAL CLASSIFICATION |journal=Acta Pathol Microbiol Scand |volume=64 |issue= |pages=31–49 |year=1965 |pmid=14320675 |doi= |url=}}</ref> - two types:
**Lauren<ref name=pmid14320675>{{cite journal |author=LAUREN P |title=THE TWO HISTOLOGICAL MAIN TYPES OF GASTRIC CARCINOMA: DIFFUSE AND  SO-CALLED INTESTINAL-TYPE CARCINOMA. AN ATTEMPT AT A HISTO-CLINICAL CLASSIFICATION |journal=Acta Pathol Microbiol Scand |volume=64 |issue= |pages=31–49 |year=1965 |pmid=14320675 |doi= |url=}}</ref> - two types:
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**WHO classification - 6 subtypes for adenocarcinoma (papillary, tubular, mucinous, signet-rign, undifferentiated, adenosquamous).<ref name=Ref_PBoD823>{{Ref PBoD |823}}</ref>
**WHO classification - 6 subtypes for adenocarcinoma (papillary, tubular, mucinous, signet-rign, undifferentiated, adenosquamous).<ref name=Ref_PBoD823>{{Ref PBoD |823}}</ref>


===Epidemiology===
===Microscopic===
*Associated with helicobacter infections.
Features - variable, either of the two following:
*Prognosis is often poor as it is discovered at a late stage.
#"Typical adenocarcinoma":
*Higher prevalence in countries in the far east (e.g. Japan) - thought to be environmental, e.g. diet.
#*Gland-forming lesion that infiltrates into the lamina propria or beyond.
#*Nuclear pleomorphism - common.
#+/-Signet ring carcinoma.
#*Scattered single cells in the lamina propria or beyond with:
#**Abundant cytoplasm containing one large (mucin-filled) vacuole.
#**A peripheral nucleus (displaced by the vacuole).


===Microscopy===
Images:
*Adenocarcinoma - gland-forming lesion.
*[http://commons.wikimedia.org/wiki/File:Gastric_adenocarcinoma.jpg Gastric adenocarcinoma (WC)].
*Signet ring carcinoma.
*[http://commons.wikimedia.org/wiki/File:Signet_ring_cells_5.jpg SRC - breast (WC)].
*[http://en.wikipedia.org/wiki/File:Gastric_signet_ring_cell_carcinoma_histopatholgy_%282%29_PAS_stain.jpg Gastric SRC - PAS stain (WC)].


===Treatment===
===IHC===
*Surgical excision.
CK7 +ve.
**Proximal tumours may require a complete gastrectomy as the stomach is innervated from its proximal part.
CK20 -ve, occasionally +ve.


=See also=
=See also=
Retrieved from "https://librepathology.org/wiki/Stomach"