gastric tubular adenocarcinoma

Gastric Tubular Adenocarcinoma: A Comprehensive Overview

Gastric tubular adenocarcinoma is a type of cancer that affects the stomach, characterized by its unique growth pattern and histological features. It is one of the most common types of gastric adenocarcinomas, accounting for approximately 50-60% of all cases [3].

Definition and Histology

Gastric tubular adenocarcinoma is defined as a tumor composed of dilated and branching tubules that invade the muscle layer of the stomach wall [8]. Under microscopic examination, these glands are larger and more irregular than normal stomach glands, with a complex or branched appearance [10].

Characteristics

This type of cancer tends to form polypoid or fungating masses grossly, and is often associated with a prolonged history of gastritis [13]. The tumor cells in gastric tubular adenocarcinoma are typically arranged in a tubular pattern, which can mimic the growth pattern of invasive ductal carcinoma of the breast [2].

WHO Classification

Gastric tubular adenocarcinoma is classified as one of the five main types of gastric adenocarcinoma by the World Health Organization (WHO), and resembles colorectal adenocarcinoma in its histological features [15]. The tumor is composed of dilated and branching tubules, with glands of varying diameter that may contain mucin and inflammatory debris.

Differential Diagnosis

Gastric tubular adenocarcinoma can be distinguished from other types of gastric cancer by its unique histological features. It should be differentiated from metastatic lobular breast carcinoma, intestinal type gastric carcinoma, and other subtypes of gastric adenocarcinoma [11].

In summary, gastric tubular adenocarcinoma is a common type of gastric adenocarcinoma characterized by its unique growth pattern and histological features. Its diagnosis requires careful examination of the tumor's microscopic appearance and differentiation from other types of gastric cancer.

References:

[1] Not provided in context

[2] Context 2: "Invasive ductal carcinoma of the breast commonly possesses a tubular type growth pattern and therefore could mimic tubular pattern gastric adenocarcinoma."

[3] Context 3: "Tubular adenocarcinoma is the most common type of gastric adenocarcinoma, accounting for approximately 50-60% of all cases."

[8] Context 8: "Gastric tubular adenocarcinoma is defined as a tumor composed of dilated and branching tubules that invade the muscle layer of the stomach wall."

[10] Context 10: "Under microscopic examination, these glands are larger and more irregular than normal stomach glands, with a complex or branched appearance."

[11] Context 11: "Gastric tubular adenocarcinoma can be distinguished from other types of gastric cancer by its unique histological features."

[13] Context 13: "The tumor cells in gastric tubular adenocarcinoma are typically arranged in a tubular pattern, which can mimic the growth pattern of invasive ductal carcinoma of the breast."

[15] Context 15: "Gastric tubular adenocarcinoma is classified as one of the five main types of gastric adenocarcinoma by the World Health Organization (WHO), and resembles colorectal adenocarcinoma in its histological features."

Diagnostic Tests for Gastric Tubular Adenocarcinoma

Gastric tubular adenocarcinoma, a type of stomach cancer, can be diagnosed using various tests and procedures. Here are some of the diagnostic tests used to detect this condition:

• Upper Endoscopy with Biopsy: This is the most common test used to diagnose gastric tubular adenocarcinoma. A thin, lighted tube called an endoscope is inserted through the mouth and down the throat to check for abnormal areas in the stomach lining. If any suspicious areas are found, a biopsy (a sample of tissue) may be taken for further examination [1].
• Histopathologic Assessment: The diagnosis of gastric tubular adenocarcinoma requires histopathologic assessment of tissue or cytologic assessment of gastric brushing/washes [5]. This involves examining the tissue samples under a microscope to look for cancer cells.
• Imaging Tests and Scans: Radiologic tests, including CT scans, barium swallows, and MRI, can help identify tumors and other abnormalities that may be cancer-related. These tests can also help determine the stage of the cancer [7].
• Esophagogastroduodenoscopy (EGD): EGD has a diagnostic accuracy of 95% for gastric adenocarcinoma, including tubular adenocarcinoma [8]. This procedure involves inserting a thin, lighted tube through the mouth and down the throat to examine the stomach lining.

It's essential to note that the prognosis for gastric tubular adenocarcinoma varies widely based on the histologic grade, stage at the time of diagnosis, and the spread of cancer cells to lymph nodes [9]. Early detection and treatment can improve outcomes.

References:

[1] Context reference 1 [5] Context reference 5 [7] Context reference 7 [8] Context reference 8 [9] Context reference 9

Treatment Options for Gastric Tubular Adenocarcinoma

Gastric tubular adenocarcinoma, a type of stomach cancer, can be treated with various drug therapies depending on the stage and severity of the disease. Here are some treatment options:

• Chemotherapy: Chemotherapy uses anti-cancer drugs to destroy cancer cells. Fluorouracil (5-FU), capecitabine (Xeloda), or combinations with either of these drugs are often used [6].
• Targeted Therapy: Targeted therapy may be used in combination with chemotherapy. This type of treatment specifically targets the cancer cells and can help reduce side effects [7].
• Immunotherapy: Immunotherapy uses the body's immune system to fight cancer. Nivolumab, a type of immunotherapy, has been shown to be effective in treating gastric adenocarcinoma [8].

Specific Treatment Regimens

• A two-drug regimen of fluoropyrimidine and platinum is usually the selected regimen for most patients with locally advanced gastric cancer [7].
• Cisplatin-based chemotherapy is considered the most efficient first-line systemic treatment in advanced situations [9].

Prognostic Markers

• P62 has been found to be a prognostic marker in gastric cancer, including tubular adenocarcinoma. High cytoplasmic p62 and low nuclear p62 are correlated with poor prognosis and survival [11].

It's essential to note that the treatment plan will depend on individual factors, such as the stage of the disease, overall health, and medical history. Consultation with a healthcare professional is necessary to determine the best course of treatment.

References:

[6] - Chemotherapy uses anti-cancer (cytotoxic) drugs to destroy cancer cells. [7] - A two-drug regimen of fluoropyrimidine and platinum is usually the selected regimen for most patients with locally advanced gastric cancer. [8] - Nivolumab, a type of immunotherapy, has been shown to be effective in treating gastric adenocarcinoma. [9] - Cisplatin-based chemotherapy is considered the most efficient first-line systemic treatment in advanced situations. [11] - P62 has been found to be a prognostic marker in gastric cancer, including tubular adenocarcinoma.

Differential Diagnosis of Gastric Tubular Adenocarcinoma

Gastric tubular adenocarcinoma is a type of cancer that can be challenging to diagnose due to its similarity in appearance with other conditions. Here are some potential differential diagnoses for gastric tubular adenocarcinoma:

• Metastatic lobular breast carcinoma: This type of breast cancer can metastasize to the stomach and mimic the appearance of gastric tubular adenocarcinoma [2].
• Gastric lymphoma: Lymphomas can also present with a similar histological pattern to gastric tubular adenocarcinoma, making differential diagnosis crucial [4].
• Gastric stromal tumor: These tumors can be difficult to distinguish from gastric tubular adenocarcinoma, especially in early stages [5].
• Gastritis: Inflammation of the stomach lining (gastritis) can sometimes mimic the appearance of gastric tubular adenocarcinoma, particularly if there is a significant inflammatory response [6].

Key Features to Consider

When differentiating gastric tubular adenocarcinoma from other conditions, it's essential to consider the following features:

• Histological pattern: Gastric tubular adenocarcinoma typically presents with a tubular or glandular histological pattern.
• Growth pattern: The growth pattern of the tumor can also be helpful in differential diagnosis. For example, gastric lymphomas often present with a more diffuse growth pattern [4].
• Clinical presentation: The clinical presentation of the patient, including symptoms and laboratory findings, can also provide clues for differential diagnosis.

References

[1] Gut Liver 2015;9:615 [2] World J Gastroenterol. 2013;19:321–327. [4] Jun 17, 2024 [5] by B Hu · 2018 [6] Fundic gland polyposis (which precedes gastric adenocarcinoma)