PET SCAN

Gastric cancer

DONE BY : MUSTAFA KHALIL IBRAHIMTBILISI STATE MEDICAL UNIVERSITY4th year, 1st semester, 2nd group

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Anatomy & physiology

Anatomy The stomach J-shaped. It has two surfaces (the anterior & posterior), two curvatures (the greater & lesser), two orifices (the cardia & pylorus). It has fundus, body and pyloric antrum.

Blood supply The left gastric arteryRight gastric arteryRight gastro-epiploic arteryLeft gastro-epiploic arteryShort gastric arteries

Gastric cancer Stomach cancer begins when cancer cells form in the inner lining of your stomach. These cells can grow into a tumor. Also called gastric cancer, the disease usually grows slowly over many years.

It could be: malignant or benign primary or secondary

Types Tumor TypePercentMalignant tumors93.0Carcinoma87.9Lymphoma3.0Leiomyosarcoma1.7Carcinoid0.3Others0.1Benign tumors7.0Polyp3.1Leiomyoma2.0Inflammatory lesions0.7Heterotopic pancreas0.4Others0.8

Adenocarcinoma (95%) : Cancer that begins in the glandular cells. Lymphoma (4%) : Cancer that begins in immune system cells .Carcinoid cancer(3%) : Cancer that begins in hormone-producing cell.Gastrointestinal stromal tumor (GIST) (1%) : Cancer that begins in nervous system tissues of stomach .The four most common primary malignant gastric neoplasms are:

Early gastric cancerDefined as a tumor confined to the mucosal or sub-mucosal layer, with or without lymph node metastasis

Advanced gastric cancerinvasion depth beyond sub-mucosal layer

Bormann classificationsGross classification phymatoid type ulcerative type infiltrative ulcerative diffuse infiltrative type

Tnm T: Primary tumorTisCarcinoma in situ; intraepithelial tumor without invasion of lamina propriaT1Tumor invades lamina propria or submucosaT2Tumor invades muscularis propria or subserosaT3Tumor penetrates serosa (visceral peritoneum) without invasion of adjacent structuresT4 Clinical ManifestationsTumor invades adjacent structuresN: Regional lymph nodeN0No regional lymph node metastasisN1Metastasis in 1 to 6 regional lymph nodesN2Metastasis in 7 to 15 lymph nodesN3Metastasis in more than 15 regional lymph nodesM: Distant metastasisM0No distant metastasisM1Distant metastasis

Spread PatternsDirect invasionLymph node disseminationBlood spreadIntraperitoneal colonization

EtiologyGastric cancer is more common in patients withpernicious anemia.blood group A.Gastric ulcer .A family history of gastric cancer. SmokingBeingoverweight orobese

Stomach surgery for an ulcerEpstein-Barr virus infectionWorking in coal, metal, timber, or rubber industriesExposure toasbestosInfection with Helicobacter pyloriLong-term stomach inflammationHad apolyplarger than 2 centimeters in your stomachA diet high in smoked, pickled, or salty foods

Signs and symotoms Early Gastric CancerAsymptomatic or silent 80%Peptic ulcer symptoms 10%Nausea or vomiting 8%Anorexia 8%Early satiety 5%Abdominal pain 2%Gastrointestinal blood loss