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Category Archives: Stomach
Stomach Carcinoid Tumors
Stomach Carcinoid Tumors
Gross appearance: look like polyps
Histology: acinar, insular, trabecular
Treatment: antrectomy, tumor resection
Gastric Carcinoma
Gastric Carcinoma
Risk factors
- smoking, nitrates, nitrites, low socioeconomic status, Japan, Helicobacter pylori, chronic gastritis
Gross appearance
- flat, ulcerated, exophytic
Histology
1) intestinal gastric carcinoma
- well formed glands, mucin in lumen (little in cytoplasm)
2) diffuse signet ring gastric carcinoma
- associated desmoplastic response
- also termed linitis plastica
- diffuse tumor seen throughout mucosa and wall
- thickened, rigid, leather bottle-like stomach
Metastases
- supraclavicular nodes (Virchow’s node)
Metastasis to ovary → Kruckenberg tumor (bilateral to ovaries)
Immunohistochemistry
- CDX2, CK7
Gastric Adenoma
Gastric Adenoma
- intestinal or gastric
- not major precursor for adenoma
Dieulafoy’s Lesion
Dieulafoy’s Lesion
Calibre-persistent artery of the stomach
• large calibre artery located in the submucosa
• gradually erodes the mucosa
• 60% mortality
Posted in Stomach
Tagged , Calibre-persistent artery, Calibre-persistent artery of the stomach, Dieulafoy Lesion, Dieulafoy's Lesion
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Gastric Antral Vascular Ectasia
Gastric Antral Vascular Ectasia (GAVE)
• gross “watermelon stomach”
• dilated capillaries in superficial lamina propria
• fibrin thrombi
• +/- fibromuscular hyperplasia of the lamina propria
Posted in Stomach
Tagged , Gastric Antral Vascular Ectasia, Gastric vascular ectasia, GAVE, Vascular ectasia, Watermelon stomach
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Reflux Gastropathy
Reflux Gastropathy
Location
- antrum, pre-pylorus
Causes
- ASA, NSAIDs, bile-reflux, post jejunal-ileal surgery
Histology
- regenerative epithelium with mucin depletion, increased tortuosity (corkscrewing) of glands, fibromuscular hyperplasia in lamina propria
- H.pylori negative
Posted in Stomach
Tagged , chemical gastropathy, Gastropathy, Reflux gastropathy, Stomach pain
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Menetrier Disease
Menetrier Disease
Clinical presentation
- hypoproteinemic, hypochlohydria gastropathy
- protein-losing gastropathy
- hypoalbuminemia
Location
- body
Histology
- elongated and dilated foveolar mucous glands
- specialized glands are absent → replaced by mucous glands
Posted in Stomach
Tagged , Gastropathy, Hypoalbuminemia, Hypochlohydria, Hypochlohydria gastropathy, Hypoproteinemic, Menetrier, Menetrier disease, Protein-losing gastropathy
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Gastric Xanthoma
Gastric Xanthoma
Gross appearance
- small yellow nodules
Histology
- lipid-laden histiocytes cells, not discrete
Immunohistochemistry and Special stains
- CD68, Sudan black, oil red O
Differential diagnosis
- signet ring carcinoma, malakoplakia, Whipple disease, MAI
Pancreatic Heterotopia
Pancreatic Heterotopia
Location
- antrum
Histology
- submucosal acinii, ducts, islets
Posted in Stomach
Tagged , Heterotopia, Pancreatic cells, Pancreatic heterotopia, Pancreatic heterotopia of the stomach, Stomach heterotopia
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Gastritis Cystica Polyposa
Gastritis Cystica Polyposa
Clinical presentation
- increased risk of colorectal and gastric carcinoma, occur near stoma site
Gross appearance
- large polyp
Histology:
- looks like HP polyp, may get glands into the muscularis
Differential diagnosis
- adenocarcinoma muscle invasion