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| Gastric
polyps and tumors |
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Polyps:
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hyperplastic: foveolar cells increased
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fundic gland: body-type mucosa with
some microcystically dilated neck areas; a certain percentage
can become adenomatous in FAP families
- hamartoma: [L10-2214?].
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adenomatous:
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gastric type: multilayered foveolar-type
cells (watch out for confusion with adenomatous-appearing
reactive change in in a fundic or hyperplastic polyp)
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intestinal type:
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Benign tumors:
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carcinoid: see info here.
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GIST: over 90% are CD117 positive; can be laporascopically wedge resected with clear margins [L07-9364].
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Malignant tumors:
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carcinoma:
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adenocarcinoma:
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well-differentiated (acinar...glandular) adenocarcinoma
problem: be on special alert with biopsies as there
are two types of pathologists concerning well differentiated gastric cancer: (a) those who
have missed a case; and, (b) those who will miss
a case. The smallest we have seen (<5mm) was able to be resected with a single-snare, snare polypectomy [S07-12805].
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early non-gland-forming adenocarcinoma: during
MALT EGD surveillance, one of our docs noted a 2
x 1.5 cm. red area on the greater curve at junction
of body & antrum in a Japanese patient; subtotal
gastrectomy fresh specimen [LMC-03-2257] was
carefully examined (visual & tactile) by two
pathologists (combined experience of 35 years) & it
was completely negative (final Dx: node neg. intramucosal
grade 3 adenocarc.).
- atypical or malignant carcinoid, info here.
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treatment: no neoadjuvant chemo
or XRT if node negative.
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lymphoma:
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plasmacytoma: [LMC-04-5089]
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sarcoma:
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GIST
(posted 29 October 2002; latest update 25 October 2007) |
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1999 - 2006, all rights reserved, Pathology Associates Of Lexington,
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