Gastric Carcinoma
Gastric carcinoma is a major global malignancy. It is predominantly adenocarcinoma, categorized into two main types with distinct clinical and pathological profiles.
1. Morphological Classification (Lauren Classification)
| Type | Key Features |
|---|---|
| Intestinal Type | Associated with H. pylori, chronic gastritis, dietary nitrosamines, and smoking. Forms glandular structures. |
| Diffuse Type | Not associated with H. pylori. Characterized by signet ring cells. Associated with E-cadherin mutation. |
2. Spread and Metastasis (Board Buzzwords)
- Virchow Node: Metastasis to the left supraclavicular node.
- Krukenberg Tumor: Bilateral metastasis to the ovaries (mucin-secreting signet ring cells).
- Sister Mary Joseph Nodule: Subcutaneous periumbilical metastasis.
- Linitis Plastica: Diffuse type malignancy that infiltrates the wall, causing a “leather bottle” appearance and loss of rugae.
3. Exam Must-Knows
- Risk Factors: Dietary habits (nitrosamines, smoked foods), chronic atrophic gastritis, H. pylori, and hereditary predisposition (CDH1 mutation in diffuse type).
Pathology Board Hint: Always look for the signet ring cell description for diffuse gastric carcinoma. Remember the mnemonic for metastasis: Virchow (node), Krukenberg (ovary), Sister Mary Joseph (umbilicus).