Philip I. Craig1,2 and Emad M. El‐Omar1 1St George & Sutherland Clinical School, University of New South Wales, Sydney, Australia 2Department of Gastroenterology and Hepatology, St George Hospital, Kogarah, New South Wales, Australia Gastric adenocarcinoma is a globally important tumor that claims the lives of thousands of patients each year. Clinically, gastric tumors are mainly diagnosed by endoscopy and confirmed by histological assessment of endoscopic biopsies. The two main histological subtypes are intestinal and diffuse. In countries with widespread screening programs for gastric cancer, the tumors are often diagnosed early, especially with the use of enhanced endoscopic imaging (e.g., narrow band imaging, NBI). In the West, most gastric cancers are diagnosed late. The use of endoscopic ultrasound (EUS) at the time of index endoscopy is very helpful in providing immediate local staging of suspected early cancers. The following seven cases demonstrate the full spectrum of gastric cancer with their associated endoscopic, histological, and EUS features. Figure 19.1 A 76‐year‐old male presented with abdominal pain and vomiting with gastric cancer. (a) Gastroscopy white light (Olympus) demonstrated a large (over 4 cm) ulcerated neoplasm involving the lesser curve of the stomach. (b) Gastric histopathology showed poorly differentiated intestinal type adenocarcinoma. (c) Endoscopic ultrasound demonstrated a 1.1 cm perigastric lymph node. (d) Lymph node histopathology showed poorly differentiated adenocarcinoma. Source: Endoscopic images courtesy of Dr Ben Terkasher and pathology images courtesy of Associated Professor Ewan Millar, St George & Sutherland Clinical School UNSW, Sydney. Figure 19.2 An 80‐year‐old female presented with vomiting and weight loss from linitis plastica. (a) Gastroscopy (Olympus) showed a 10 cm diffusely abnormal gastric fundus and body which distended poorly. However, initial biopsies were negative and so repeat deep snare biopsies were taken. (b)
CHAPTER 19
Tumors of the stomach
Case 1
Case 2
Related posts:
Stay updated, free articles. Join our Telegram channel
Full access? Get Clinical Tree
