gastric carcinoma

• 3rd most common GI malignancy (after colorectal + pancreas)
• 95% adenocarcinoma (rarely squamous cell or adenoacanthoma)

• predisposing factors:
  • pernicious anemia (2X risk)
  • chronic atrophic gastritis
  • adenomatous + villous polyp (7-27% are malignant)
  • gastrojejunostomy

1. polypoid / fungating
2. ulcerating / penetrating (70%)
3. infiltrating / scirrous = linitis plastica
   • increase in fibrous tissue; aperistalsis; rigidity
4. superficial spreading carcinoma
   • confined to mucosa/submucosa; 95% 5-year survival
   • patch of nodularity; little loss of elasticity

• 60% lesser curvature
• 30% GE junction
• 10% greater curvature

• fundus 90%
• greater curvature 70%
• lesser curvature 10-15%

© 2002, C.E. Kahn, Jr.
2002-04-18