Clinical features

The most frequent presenting symptoms are right upper abdominal epigastric pain or discomfort, weight loss and fever 1043, 1217 . Most cases are solitary or multiple masses within the liver which may be misdiagnosed as a primary liver tumour or metastatic cancer 1043, 1217 . Some cases have been reported with diffuse infiltration of the liver associated with hepatomegaly but without a discrete mass, simulating hepatic inflammation 668 . Hepatosplenic T-cell lymphomas present with...

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Fig. 2.03 Pathogenetic pathways operative in the evolution of oesophageal and gastric carcinoma. Intestinal metaplasia is a common precursor lesion that may result from gastro-oesophageal reflux disease (GERD) or chronic H. pylori infection. Features of intestinal metaplasia in the oesophagus and stomach. H. pylori association Yes No Usual type of Barrett cytokeratin pattern No Yes Common presenting symptoms for patients with adenocarcinomas of the oesophagogastric junction include dys-phagia,...

Precursor lesions

Gallbladder Adenoma Biliary Type

Adenomas are benign neoplasms of glandular epithelium (intraepithelial neoplasia) that are typically polypoid, single and well-demarcated. They are more common in women than in men 42 . There is a wide age range although mostly a disease of adults rare gallbladder adenomas occur in children 1256, 2126 . They are more common in the gallbladder than in the extrahepatic bile ducts, and are found in 0.3-0.5 of gallbladders removed for cholelithiasis or chronic cholecystitis. A small proportion of...

Gallbladder carcinoma

Papillary Adenocarcinoma Gallbladder

The incidence of gallbladder cancer is higher in patients with gallstones than in patients without stones 35 , and stones are present in over 80 of gallbladder carcinomas. The incidence of gallbladder carcinoma parallels that of gallstones, being more frequent in females and in certain ethnic groups, e.g. Native Americans, who have a high incidence of stones. Nevertheless, although gall stones are considered a risk factor, the overall incidence of carcinoma of the gallbladder in...

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Fig. 6.30 Adenomas with high-grade dysplasia. A Loss of normal glandular architecture, hyperchromatic cells with multi-layered irregular nuclei and loss of mucin, high nuclear cytoplasmic ratio. B Marked nuclear atypia with prominent nucleoli. C Adenoma with focal cribriform pattern . Fig. 6.31 Serrated adenoma with irregular indentation of the neoplastic epithelium. Fig. 6.31 Serrated adenoma with irregular indentation of the neoplastic epithelium. Development of carcinoma Is apparently...

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Fig. 8.11 Hepatocellular carcinoma in a 17-year old patient with Fanconi anaemia. A Green bile staining and extensive necrosis and haemorrhage. B Trabecular and pseudoglandular pattern with bile plugs. Invasion into the blood vessels, in particular into the portal vein, is a characteristic of HCC. Tumour thrombi in the portal veins are present in more than 70 of autopsies of advanced HCCs. Intra-hepatic metastases is caused mostly by tumour spread through the portal vein branches. Tumour...

Of the colon and rectumRHrSnobdn

Endocrine tumours of the large intestine are defined as in the small intestine. Endocrine tumours of the colon have an incidence of 0.07-0.11 up to 0.21 cases per 100,000 population per year 1251 . In a recent series, carcinoids from caecum to transverse colon (midgut) represented about 8 and descending colon and rectosigmoid (hindgut) carcinoids about 20 of 5973 gastrointestinal carci-noids 1251 . Rectal carcinoids had a reported incidence of 0.14-0.76 cases per 100,000 population per year. In...

M1

This classification applies only to primary hepatocellular and cholangio-(intrahepatic bile duct) carcinomas of the liver. 2 A help desk for specific questions about the TNM classification is available at http tnm.uicc.org. 3 For classification, the plane projecting between the bed of the gallbladder and the inferior vena cava divides the liver in two lobes. S. Hirohashi K.G. Ishak M. Kojiro I.R. Wanless N.D. Theise H. Tsukuma H.E. Blum Y. Deugnier P. Laurent Puig H.P. Fischer M....

C

The non-neoplastic mucosa distant from an anaplastic large cell intestinal T-cell lymphoma displays villous atrophy, crypt hyperplasia (A) and an increase in cytologically unremarkable intraepithelial lymphocytes (B) without evidence of lymphoma. Both the lymphoma (ALCL) and the intraepithelial lymphocytes (IEL) share the same dominant T-cell clone (C) and the same aberrant immunological phenotype. band-like or patchy microscopic lesions entirely confined to the...

Prognosis and predictive factors

Ductal adenocarcinoma is fatal in most cases 639 . The mean survival time of the untreated patient is 3 months, while the mean survival after radical resection varies from 10-20 months 560, 692, 814, 1955 . The overall 5-year survival rate of patients treated by resection is 3-4 639 , although in selected and stage-stratified series survival figures approaching 25 or even 46 have been reported 560, 1955, 1966, 1976 . Unresectable carcinomas are treated with palliative bypass operations....

Adenocarcinoma of the oesophago SJ Spechlerp Hainaut

Oesophagogastric Junction

Adenocarcinomas that straddle the junction of the oesophagus and stomach are called tumours of the oesophagogastric (OG) junction. This definition includes many tumours formerly called cancers of the gastric cardia. Squamous cell carcinomas that occur at the OG junction are considered carcinomas of the distal oesophagus, even if they cross the OG junction. Definition of the oesophagogastric junction The OG junction is the anatomical region where the tubular oesophagus joins the stomach. The...