配套课件 病理学 消化系统（2004必威体育精装版用）%282%29食管癌、胃癌、大肠癌.pptVIP

This is an example of linitis plastica, a diffuse infiltrative gastric adenocarcinoma which gives the stomach a shrunken leather bottle appearance with extensive mucosal erosion and a markedly thickened gastric wall. This type of carcinoma has a very poor prognosis. The endoscopic view of this lesion is shown below, with extensive mucosal erosion. ②镜下： 乳头状腺癌 管状腺癌 粘液腺癌； 印戒细胞癌 （二）胃癌（carcinoma of stomach） 1、病 变 （1）好发部位 （2）组织来源 1）早期胃癌 （3）类 型 2）进展期胃癌 ①肉眼： 1）息肉型/蕈伞型 2）溃疡型 3）浸润型 4）胶样型 A moderately differentiated gastric adenocarcinoma is infiltrating up and into the submucosa below the squamous mucosa of the esophagus. The neoplastic glands are variably sized. At higher magnification, the neoplastic glands of gastric adenocarcinoma demonstrate mitoses, increased nuclear/cytoplasmic ratios, and hyperchromatism. There is a desmoplastic stromal reaction to the infiltrating glands. This is a signet ring cell pattern of adenocarcinoma in which the cells are filled with mucin vacuoles that push the nucleus to one side, as shown at the arrow. 1）直接蔓延 2）转移 （二）胃癌（carcinoma of stomach） 1、病 变 2、扩散途径 At autopsy, the thoracic cavity and abdominal cavity are both opened to reveal the stomach just to the right and below the edge of liver in this photograph. Gastric adenocarcinoma has infiltrated through the wall and appears on the surface as irregular tan masses. The extensive tumor in this case caused gastric outlet obstruction. 授人鱼 不如 授人渔 第八章 消化系统疾病 第一节 胃肠疾病 一、胃炎 GO 二、消化性溃疡 GO 三、消化道肿瘤 GO 第二节 肝胆疾病 一、病毒性肝炎 GO 二、肝硬化 GO P 187 P196 三、消化系统 常见肿瘤 （一）食管癌（carcinoma of esophagus） 1、病 因 P196 2、病 变 （1）好发部位： 中段下段上段 （一）食管癌（carcinoma of esophagus） 1、病 因 P196 （2）组织来源： 食管鳞状上皮 腺上皮 ①定义：指癌细胞浸润粘膜下层及以上， 无症状，无转移。 ②肉眼：无明显改变。 ③光镜：多为原位癌（鳞癌） ④诊断：困难，发现率仅为6%左右。 ⑤预后：较好，5年生存率90%。 （3）类 型 1）早期癌 2、病 变 （一）食管癌（carcinoma of esophagus） 1、病 因 2）中晚期癌 （3）类 型 2、病 变 （一）食管癌（carcinoma of esophagus） 1、病 因 1）早期癌 肉 眼 镜 下 1