Carcinoma of Stomach Causes Helicobacter pylori infection ●Smoking Autoimmune atrophic gastritis,intestinal metaplasia,and genetic factors Morphology 分 Polypoid/fungating carcinoma Ulcerating/penetrating carcinoma (70%) Infiltrating/scirrhous type=linitis plastica Superficial spreading type-confined to mucosa/submucosa-NOT linitis plastic 10 Early Gastric Cancer Double-contrast barium upper GI examination is widely recognized as the radiologic technique of choice for diagnosing early gastric cancers. These lesions are confined to the mucosa or submucosa and are classified into 3 types Type I-Elevated lesions that protrude more than 5 mm into the lumen Type II-Superficial lesions that are elevated (IIa),flat(IIb),or depressed (IIc) Type III-Shallow,irregular ulcers surrounded by nodular,clubbed mucosal folds Advanced carcinoma o Polypoid carcinomas(an example of which appears below)are lobulated masses that protrude into the lumen.They may contain I or more areas of ulceration. With ulcerated carcinomas,an irregular crater is located in a rind of malignant tissue. ● Infiltrating carcinomas result in irregular narrowing of the stomach,with nodularity or spiculation of the mucosa. 44 Carcinoma of Stomach Causes ⚫ Helicobacter pylori infection ⚫ Smoking ⚫ Autoimmune atrophic gastritis, intestinal metaplasia, and genetic factors. Morphology ⚫ Polypoid/fungating carcinoma ⚫ Ulcerating/penetrating carcinoma (70%) ⚫ Infiltrating/scirrhous type=linitis plastica ⚫ Superficial spreading type-confined to mucosa/submucosa-NOT linitis plastic Early Gastric Cancer Double-contrast barium upper GI examination is widely recognized as the radiologic technique of choice for diagnosing early gastric cancers. These lesions are confined to the mucosa or submucosa and are classified into 3 types: Type I - Elevated lesions that protrude more than 5 mm into the lumen Type II - Superficial lesions that are elevated (IIa), flat (IIb), or depressed (IIc) Type III - Shallow, irregular ulcers surrounded by nodular, clubbed mucosal folds Advanced carcinoma ⚫ Polypoid carcinomas (an example of which appears below) are lobulated masses that protrude into the lumen. They may contain 1 or more areas of ulceration. ⚫ With ulcerated carcinomas, an irregular crater is located in a rind of malignant tissue. ⚫ Infiltrating carcinomas result in irregular narrowing of the stomach, with nodularity or spiculation of the mucosa. 5’ 5’ 10’ 10’