lecture notes for medical students

1. Tips on using my ppt.
1. You can freely download, edit, modify and put your
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2. Don’t be concerned about number of slides. Half the
slides are blanks except for the title.
3. First show the blank slides (eg. Aetiology ) > Ask
students what they already know about ethology of
today's topic. > Then show next slide which enumerates
aetiologies.
4. At the end rerun the show – show blank> ask questions >
show next slide.
5. This will be an ACTIVE LEARNING SESSION x
three revisions.
6. Good for self study also.
7. See notes for bibliography.

2. Objectives
1.

3. Objectives
1. Introduction & History
2. Relevant Anatomy, Physiology
3. Aetiology
4. Pathophysiology
5. Pathology
6. Classification
7. Clinical Features
8. Investigations
9. Management
10. Prevention
11. Guidelines
12. Take home messages

4. Introduction & History.

5. Introduction & History.
• Primary gastric lymphoma
• Involvement of the stomach in a generalised
lymphomatous process.
• Unlike gastric carcinoma, the incidence of
lymphoma seems to be increasing.

6. Pathology: Histological types

7. Pathology: Histological types
• Adenocarcinoma - 90-95%
• Lymphomas - 1-5%
• Gastrointestinal stromal tumors (GIST
formerly classified as either leiomyomas or
leiomyosarcomas) - 2%
• Carcinoids - 1%
• Adenoacanthomas - 1%
• Squamous cell carcinomas - 1%

8. Aetiology

9. Aetiology
• Idiopathic
• Congenital/ Genetic
• Nutritional Deficiency/excess
• Traumatic
• Infections /Infestation
• Autoimmune
• Neoplastic (Benign/Malignant)
• Degenerative / lifestyle
• Iatrogenic
• Psychosomatic
• Poisoing/ Toxins/ Dtug induced

10. Aetiology
• Idiopathic
• Congenital/ Genetic
• Nutritional Deficiency/excess
• Traumatic
• Infections /Infestation
• Autoimmune
• Neoplastic (Benign/Malignant)
• Degenerative / lifestyle
• Iatrogenic
• Psychosomatic
• Poisoing/ Toxins/ Dtug induced

11. Aetiology Of Aetiology
•

12. Aetiology Of Aetiology
• Continued massive antigen stimulation .- H.Pylori.

13. Pathophysiology

14. Pathophysiology
• Primary gastric lymphomas are B-cell
derived from Mucosa-associated lymphoid
tissue (MALT)/ gut-associated lymphoid
tissue (GALT),.

15. Pathology
•

16. Pathology
• Diffuse mucosal thickening, which may ulcerate.
• Lymph node involvement is late.

17. Staging

18. Staging
Same definitionsnon-Hodgkin lymphomas
(NHLs)

19. Staging
Same definitions non-Hodgkin lymphomas
(NHLs)
• Stage IE – Lymphoma is present in only 1
area or organ outside the lymph nodes
• Stage IIE – the same side of the diaphragm
• Stage IIIE – Lymphoma is present on both
sides of the diaphragm
• Stage IV – widespread to several organs,

20. Clinical Features
•

21. Clinical Features
• Demography
• Symptoms
• History
• Signs
• Prognosis
• Complications

22. Demography

23. Demography
• Geographical distribution.
• Age
• Sex
• Temporal behaviour

24. Demography
• Gastric lymphoma is most common in the
sixth decade

25. Symptoms

26. Symptoms
Same as gastric cancer –
• Abd.pain
• weight loss
• bleeding.
• haematemesis perforation or obstruction
are not common.

27. Other Symptoms
• Chronic fatigue
• Low-grade fevers
• Nausea
• Constipation
• Tarry stools
• Epigastric pain
• Weight loss
• Anemia
• Shortness of breath

28. Prognosis

29. Prognosis
• Generally good.
• Depends on the grade of the tumor.
• The survival rate for stage IE disease is
93% at 5 years and 58% at 10 years.

30. Investigations

31. Investigations
• Laboratory Studies
– Routine
– Special
• Imaging Studies
• Tissue diagnosis
– Cytology
• FNAC
– Histology
– Germline Testing and Molecular Analysis
• Diagnostic Laparotomy.

32. Investigations
• Laboratory Studies
– Routine
– Special
• Imaging Studies
• Tissue diagnosis
– Cytology
• FNAC
– Histology
– Germline Testing and Molecular Analysis
• Diagnostic Laparotomy.

33. Diagnostic Studies

34. Diagnostic Studies
Imaging Studies
• X-Ray
• USG
• CT
• Angiography
• MRI
• Endoscopy
• Nuclear scan

35. Diagnostic Studies
Imaging Studies
• X-Ray
• USG
• CT Chest and abdomen
• Angiography
• MRI
• Endoscopic Biopsy.
• Nuclear scan PET-CT*

36. Diagnostic Studies
For-
1. Staging
2. For diffentiating primary from
generalised lymphoma
• CT scans of the chest and abdomen
• Bone marrow aspirate
• Full blood count
• PET-CT.

37. Management

38. Management
• Localised diseased – Surgery.
• Systemic – Chemotherapy.
• H. Pylori eradication
• Surgery for perforation or bleeding

39. Prevention

40. Prevention
• H. Pylori eradication.

41. Get this ppt in mobile
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43. Get this ppt in mobile
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4. Scan qr code from
next slide.

44. Get this ppt in mobile

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