Stomach tumors

Adenokarcinoma of stomach

Adenokarcinoma of stomach – HE mount

Carcinoma of stomach

The tumors of the stomach include all neoplasms arising from the tissues of the stomach. The basic division is into benign and malignant tumors. Benign tumors of the stomach include polyps (most often inflammatory and hyperplastic), as well as less common leiomyomas, lipomas, fibromas, neurinomas and hemangiomas. The most common malignant tumor in the stomach is cancer, more specifically adenocarcinoma. We also find lymphomas, carcinoids and stromal tumors.

Benign tumors of the stomach

• The most common are polyps (from the epithelium of the gastric glands), followed by leiomyomas (solitary tumors arching the mucosa, manifested by bleeding, tendency to malignant), lipomas, fibromas, neurinomas and hemangiomas.
• Clinically mostly asymptomatic, can cause passage disorders (large tumors in the pyloric area), bleeding, diagnosis of GFSK with biopsybiopsy.
• Treatment - local excision (and preferably perioperative biopsy), in case of large tumors or suspected malignancy is used gastric resection.
• Gastric karcinoid accounts for 5% of all carcinoids (most common in the apendix and ileum), gastric carcinoid has a higher risk of malignancy than in other locations.

Gastric carcinoma

Gastric carcinoma is a cancer of the stomach wall that is currently the fourth leading cause of cancer death in Europe. It is the second most common malignant disease worldwide. Gastric cancer develops through a complex multistage process with several distinct histological and pathophysiological phases. The whole development is influenced by a complex of interactions between bacteria, the environment, the genetic dispositions of the host and molecular mechanisms. Many of the etiologies and pathogenesis of this disease remain unclear, but the underlying context is already known.

Gastric lymphomas

1. Non-Hodgkin's lymphoma..
   • Primary lymphoma is limited to the stomach and possibly adjacent nodules, blood count and pulp normal.
   • Secondary gastric lymphoma occurs as a manifestation of systemic lymphoma in up to 25%.
   • Symptoms such as carcinoma, often manifested by complications (bleeding, obstruction, perforation).
   • Classification of primary gastric lymphomas:
     • lymphoma with a high degree of malignancy – chemotherapy, or supplemented by radiotherapy;
     • MALToma (lymphoma with a low degree of malignancy) – caused by Helicobacter pylori infection – eradication treatment.
2. Hodgkin's lymphoma.
   • Primary gastric lymphogranuloma is very rare, it is almost always a systemic disease.
   • Treatment by gastric resection followed by chemotherapy.

Mesenchymal tumors of the stomach

Gastric mesenchymal tumors (GIST) are rare (1% of gastric cancers).

• Formerly classified as leiomyomas / leiomyosarcomas x composition corresponds more to primitive mesenchymal structures (Cajal cells) → collective designation gastrointestinal stromal tumors (GIST).
• Uncertain biological behavior; different growth activity (benign / malignant).
• Often a source of bleeding, they can grow to considerable size.

Diagnostics

• endoUSG.

Therapy

• surgical.

Links

Related articles

• Stomach
• Stomach carcinoma

References

• KLENER, P, et al. Vnitřní lékařství. 3. edition. Praha : Galén, 2006. ISBN 80-7262-430-X.

• PASTOR, Jan. Langenbeck's medical web page [online]. [cit. 03-10-2009]. <http://langenbeck.webs.com>.