Pathology Cheat Sheet
Follow the Mucosal Injury
Gastric pathology for NEET-PG: H. pylori peptic ulcer, four ulcer zones, intestinal vs diffuse gastric carcinoma, signet-ring cells, and linitis plastica.
MedNext Academy | 3 min read
Follow the Mucosal Injury
Gastric pathology for NEET-PG: H. pylori peptic ulcer, four ulcer zones, intestinal vs diffuse gastric carcinoma, signet-ring cells, and linitis plastica.
Oral cancer, peptic ulcer disease and gastric carcinoma, tracing mucosal injury from inflammation to malignancy.
High-yield lines
- Oral squamous cell carcinoma is linked to tobacco, areca nut, and alcohol and often arises from leukoplakia or erythroplakia.
- Erythroplakia carries a higher risk of malignant transformation than leukoplakia.
- Peptic ulcer disease is caused mainly by Helicobacter pylori infection and NSAID use.
- Duodenal ulcers relate to increased acid and are almost always benign, while gastric ulcers may harbour malignancy and need biopsy.
- The peptic ulcer base shows four microscopic zones: necrotic debris, inflammation, granulation tissue, and fibrosis.
- Helicobacter pylori is a curved Gram-negative rod that colonises the gastric antrum and produces urease.
- Chronic H. pylori gastritis and intestinal metaplasia predispose to gastric adenocarcinoma and MALT lymphoma.
- Intestinal-type gastric carcinoma forms glands and is linked to intestinal metaplasia, while diffuse-type shows signet-ring cells.
- Diffuse gastric carcinoma with signet-ring cells causes linitis plastica, a rigid leather-bottle stomach.
- Signet-ring cells contain intracytoplasmic mucin that pushes the nucleus to the periphery.
- Virchow node is a left supraclavicular node metastasis, and Krukenberg tumour is ovarian spread of signet-ring carcinoma.
- Gastric MALT lymphoma can regress after eradication of Helicobacter pylori.
Mapped competency codes
- PA24.1
- PA24.2
- PA24.3
- PA24.4
Continue into the full chapter
This summary maps to PA24-gastrointestinal-tract.
Frequently Asked Questions
What organism is the main cause of peptic ulcer disease?
Helicobacter pylori, a curved Gram-negative urease-producing bacterium, along with NSAID use as the other major cause.
How do intestinal-type and diffuse-type gastric carcinoma differ?
Intestinal-type forms glands and arises from intestinal metaplasia, while diffuse-type is composed of signet-ring cells and can produce a leather-bottle linitis plastica stomach.
What is a signet-ring cell?
A malignant cell filled with intracytoplasmic mucin that displaces the nucleus to the periphery, characteristic of diffuse gastric carcinoma.
Why must a gastric ulcer be biopsied?
Because unlike duodenal ulcers, gastric ulcers may be malignant, so biopsy of the margins is required to exclude carcinoma.
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