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aetiopathogenesis
environmental factor
diet
-nitrite derived from nitrate
-smoked and salted food
-lack of fresh fruit and vegetable
low socio-economic status
cigarette smoking
host factors
chronic gastritis dt H.pylori
autoimmune gastritis
partial gastrectomy
gastric adenomas
barret esophagus
atrophic gastritis
genettic factor
inc risk with blood gp A
family history of gastric cancer
hereditary non polyposis colon cancer syndrome
familial gastric carcinoma (E-cadherin mutation)
modes of transmission
Virchow (sentinel) node→ left supraclavicular node
Sister Joseph Mary nodule→ subciutaneous nodule in periumbilical node
Krukenberg tumor→ spread to ovary
Paraneoplastic skin lesion → Acanthosis nigricans
gross
location
cardia of stomach
body and fundus
pylorus and antrum
flat, polypoid and excavated lesion
ulcer >3cm, heaped up margin, necrotic ulcer base
histologically
intestinal type
gland forming adenocarcinoma
diffuse type
not related to H.pylori
diffuse infiltration of stomach by poorly differentiated tumor cells
Signet ring cells
nucleus is displaced to periphery by intracellular mucin