Difference between revisions of "Stomach"

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Revision as of 18:12, 18 December 2012

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==Adenomatous polyps==
==Adenomatous polyps==
===General===
===General===
*Divided into "gastric" and "intestinal type". (???)
Common subclassification:<ref>URL: [http://surgpathcriteria.stanford.edu/gitumors/gastric-adenoma/printable.html http://surgpathcriteria.stanford.edu/gitumors/gastric-adenoma/printable.html]. Accessed on: 18 December 2012.</ref>
*Intestinal: goblet cells or Paneth cells.
*Gastric: foveolar epithelium.
 
Foveolar:
*Associated with [[familial adenomatous polyposis]] (FAP).
 
Intestinal:
*Not associated with FAP.


*Can be grouped various ways.<ref name=pmid18384215>{{Cite journal  | last1 = Park | first1 = do Y. | last2 = Lauwers | first2 = GY. | title = Gastric polyps: classification and management. | journal = Arch Pathol Lab Med | volume = 132 | issue = 4 | pages = 633-40 | month = Apr | year = 2008 | doi = 10.1043/1543-2165(2008)132[633:GPCAM]2.0.CO;2 | PMID = 18384215 | url=http://www.archivesofpathology.org/doi/full/10.1043/1543-2165(2008)132%5B633:GPCAM%5D2.0.CO;2 }}</ref> (???)
Note:
*These polyps can be grouped various ways.<ref name=pmid18384215>{{Cite journal  | last1 = Park | first1 = do Y. | last2 = Lauwers | first2 = GY. | title = Gastric polyps: classification and management. | journal = Arch Pathol Lab Med | volume = 132 | issue = 4 | pages = 633-40 | month = Apr | year = 2008 | doi = 10.1043/1543-2165(2008)132[633:GPCAM]2.0.CO;2 | PMID = 18384215 | url=http://www.archivesofpathology.org/doi/full/10.1043/1543-2165(2008)132%5B633:GPCAM%5D2.0.CO;2 }}</ref>


===Microscopic===
===Microscopic===
===Types===
====Foveolar type adenomatous polyp====
*Intestinal: goblet cells or Paneth cells.
Features:
*Gastric: foveolar epithelium.
*Hyperchromasia at the surface - '''key feature'''.
*Cytoplasm with (shortened) champagne flute-like luminal aspect (apical mucin caps).
*Nuclear changes:
**Hyperchromasia.
**Enlargement.
*No intestinal metaplasia.
 
DDx:
*[[Gastric carcinoma]].
*[[Reactive changes]].


====Intestinal type adenomatous polyp====
Features - intestinal:
Features - intestinal:
*Architecture: crowding of glands.
*[[Intestinal metaplasia of the stomach|Intestinal metaplasia]].
*Hyperchromasia of cytoplasm.
*Hyperchromasia of cytoplasm.
*Nuclear changes:
*Nuclear changes:
**Loss of nuclear polarity.
**Loss of nuclear polarity.
**Increased [[NC ratio]].
**Increased [[NC ratio]].
**Elongation of nucleus.
**Elongation of nucleus and pseudostratification.


DDx:
DDx:
*[[Gastric carcinoma]].
*[[Gastric carcinoma]].
*[[Reactive changes]].
*[[Reactive changes]].
*[[Intestinal metaplasia of the stomach|Intestinal metaplasia]].


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