Klara Matijevi Mentor A mega Horvat adenocarcinoma gastrointestinal

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Klara Matijević Mentor: A. Žmegač Horvat

Klara Matijević Mentor: A. Žmegač Horvat

adenocarcinoma gastrointestinal stromal tumours (GIST) primary gastric lymphoma gastric polyps

adenocarcinoma gastrointestinal stromal tumours (GIST) primary gastric lymphoma gastric polyps

ADENOCARCINOMA 4 th most common cancer world-wide 2 nd leading cause of cancer-related mortality

ADENOCARCINOMA 4 th most common cancer world-wide 2 nd 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

H. pylori infection (group 1 gastric carcinogen) dietary factors smoking tobacco genetic abnormalities increased risk after partial gastrectomy

Normal gastric mucosa H. Pylori infection Acute gastritis Chronic active gastritis Atrophic gastritis Intestinal

Normal gastric mucosa H. Pylori infection Acute gastritis Chronic active gastritis Atrophic gastritis Intestinal metaplasia Dysplasia Advanced gastric cancer Diagram showing the development of gastric cancer associated with H. pylori infection

Lauren classification: • intestinal type • diffuse type • diffuse carcinoma of linitis plastica

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

Borrmann classification: • polypoid • ulcerating • ulceroinfiltrative • infiltrative • gastric adenocarcinoma of ulcerative type • gastric adenocarcinoma of polypoid type

Stage Grouping TNM classification: . Stage 0 Tis N 0 M 0 Stage IA

Stage Grouping TNM classification: . Stage 0 Tis N 0 M 0 Stage IA T 1 N 0 M 0 Stage IB T 1 N 1 M 0 T 2 a/b N 0 M 0 T 1 N 2 M 0 T 2 a/b N 1 M 0 T 3 N 0 M 0 T 2 a/b N 2 M 0 T 3 N 1 M 0 T 4 N 0 M 0 Stage IIIB T 3 N 2 M 0 Stage IV T 4 N 1– 3 M 0 T 1– 3 N 3 M 0 Any T Any N M 1 Stage IIIA

advanced disease at the time of presentation symptoms at early stage: fullness in

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 2. lab findings 3. 4. 5. non-specific findings

1. patient history + physical examination 2. lab findings 3. 4. 5. non-specific findings FBC + LFT barium meal ENDOSCOPY (EGD) !!! staging: chest X-ray abdominal US CT scan

endoscopic removal (only early non-ulcerated mucosal lesions) surgery chemotherapy radiotherapy palliative care

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

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

benign rarely produce symptoms types: hyperplastic adenomatous cystic gland polyps inflammatory fibroid polyps treatment : endoscopic excision

Kumar and Clark: Clinical Medicine (7 th edition) B. Vrhovac, B. Jakšić, Ž.

Kumar and Clark: Clinical Medicine (7 th edition) B. Vrhovac, B. Jakšić, Ž. Reiner, B. Vucelić: Interna medicina www. pathconsultddx. com