Pathology - Stomach

Question 1

Which one is a chief cell and which one is a parietal cell?

Answer 1

1. Chief cell
2. Parietal cell

Chief cells are purple, parietal cells are pink

Question 2

Why are parietal cells pink?

Answer 2

They have a lot of mitochondria to power the H+/K+ ATPase for acid secretion.

Question 3

What are the products of parietal cells?

Answer 3

Acid, intrinsic factor

Question 4

What do chief cells make?

Answer 4

Pepsinogen

Question 5

Name three things that can cause acute gastritis.

Answer 5

1. H. pylori (early in infection)
2. NSAIDs
3. Alcohol

Question 6

Chronic gastritis caused by autoimmune disease can also lead to what two sequelae due to destruction of parietal cells?

Answer 6

Megaloblastic anemia (no B12 cuz of no IF) and achlorhydria (no HCl)

Question 7

Name four shitty things that H. pylori can cause.

Answer 7

1. Gastritis (atrophic w/ loss of parietal cells –> achlorhydria and B12 deficiency)
2. Ulcers in stomach and duodenum
3. Gastric adenocarcinoma
4. MALT lymphoma

Question 8

What can be seen histologically from a biopsy in a patient with H. pylori?

Answer 8

1. You can see the bugs!
2. Lymphocytic infiltration
3. Germinal centers sometimes

Question 9

What are the two types of gastric adenocarcinoma? Describe their associations and characteristics.

Answer 9

Intestinal type - associated with H. pylori, chronic gastritis, and dietary nitrosamines (in smoked meats)

Diffuse Linitis Plastica type - not associated w/ H. pylori; signet ring cells are characteristic; makes the stomach like a leather bag

Question 10

An older patient presents for routine check-up and you note an enlarged left supraclavicular lymph node. What is this node called and what are you concerned about?

Answer 10

Virchow’s node - possible sign of gastric adenocarcinoma

Question 11

Other than a Virchow’s node, what are two other common sites of metastasis of gastric adenocarcinoma?

Answer 11

Subcutaneous periumbilical metastasis –> Sister Mary Joseph’s nodule

Metastasis to ovaries –> Krukenberg tumor

Question 12

Gastrointestinal stromal tumors (GIST) originate from _________ cells of ______, which are involved in peristalsis. They often have mutations in ______.

Answer 12

originate from interstitial cells of Cajal; often have C-kit mutations.