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Stomach· Chapter 07

Gastritis, Gastric Cancers, and Submucosal Tumors

Autoimmune atrophic gastritis through to type 1 gastric NETs, OLGA and OLGIM staging, MALT lymphoma, and Lauren intestinal versus diffuse adenocarcinoma. Plus FLOT timing, GIST risk stratification with the TKI sequence, ZES versus Menetrier, and the submucosal tumor evaluation pathway.

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49 MCQs2 podcast episodes
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What this chapter covers

  • Section 7.1: Autoimmune atrophic gastritis and pernicious anemia

    Autoimmune atrophic gastritis is the prototype of chronic non-H. pylori gastritis, and the entire phenotype falls out of one sentence about anatomy: autoimmune destruction of parietal cells is corpus-predominant and antral-sparing, and every downstream manifestation tracks the location of the lesion.

  • Section 7.2: H. pylori cancer precursor cascade and Menetrier disease

    Chronic gastritis from H. pylori does not become gastric cancer overnight.

  • Section 7.3: Zollinger-Ellison syndrome

    Zollinger-Ellison syndrome is the gastrin-driven ulcer disease that masquerades as refractory peptic ulcer disease, and the boards present it as the diagnosis the candidate should suspect in any of five scenarios: multiple ulcers, ulcers in unusual locations distal to the duodenal bulb, ulcers refractory to standard therapy, ulcers combined with secretory diarrhea, or ulcers in a patient with a family history of MEN1.

  • Section 7.4: Gastric adenocarcinoma

    Gastric adenocarcinoma sorts cleanly into two histologic types, and the Lauren classification is the framework the boards expect the candidate to use.

  • Section 7.5: MALT lymphoma and gastric DLBCL

    Gastric lymphoma accounts for less than 5 percent of gastric neoplasms, but it occupies a disproportionate share of the boards because the management of the two main types diverges sharply at the first decision point.

  • Section 7.6: Gastric NETs (carcinoid)

    Gastric neuroendocrine tumors arise from enterochromaffin-like (ECL) cells in the body and fundus or from enterochromaffin cells, and the boards group them into three types because the type sorts cleanly along the gastrin axis and dictates the management.

  • Section 7.7: GIST

    Gastrointestinal stromal tumor is the model targeted-therapy GI cancer, and the boards test it because the molecular biology, the endosonographic appearance, and the drug selection align in a tight teaching package.

Podcast episodes

  1. 01

    Atrophic Correa ZES

    This episode covers the chronic gastritides and the precursor lesions: autoimmune atrophic gastritis, the H. pylori cascade toward cancer, Menetrier disease, and Zollinger-Ellison syndrome.

  2. 02

    Gastric Tumors MALT NET GIST

    This episode covers the gastric tumors: adenocarcinoma split by Lauren type, MALT lymphoma versus the more aggressive large B-cell lymphoma, the three types of gastric neuroendocrine tumor, and the GIST as the model targeted-therapy cancer.