intestinaltumor__培训课件.ppt

Survival of GIST patients treated with Imatinib is good with stable disease S.I. HEMANGIOMA Hemangiomas of the small bowel are rare vascular tumors of 3 types: capillary, cavernous (most common), and mixed. Hemangiomas may be solitary or multiple and may account for up to 13% of small bowel lesions. Preoperative arteriography or intraoperative maneuvers, such as transillumination or ultrasound, may be employed to increase localization success. GI bleeding is a frequent complication. The blood loss may be occult (resulting in chronic anemia) or acute. S.I. NEUROMA Also, all patients with MEN 2B have intestinal neuromas. Neurofibromatosis type 1 (von Recklinghausen disease of nerve) affects the GIT in up to 25% of cases, and in such cases is characterized by multiple submucosal neurofibromas. Patholoy shows spindle cells in loose fibromyxoid background, spindle cells may expand the lamina propria and separate the crypts Spindle cells stains with S100, chromogranin, neuron specific enolase S.I. POLYPS ? Familial adenomatous polyposis  ? Gardners syndrome.  ? Lynchs syndrome.  ? Turcots syndrome.  ? Peutz-Jeghers syndrome.  ? Juvenile polyposis. MALIGNANT SMALL INTESTINAL NEOPLASMS EPIDEMIOLOGY Prevalence: prevalence is lower in less industrialized countries. In addition, lymphomas are predominant in less developed countries. Race: higher prevalence rates for blacks than for whites Sex: Males have higher prevalence compared with females, with a ratio of 1.4:1 Age: The prevalence tends to increase with age RISK FACTORS Familial adenomatous polyposis Hereditary nonpolyposis colorectal cancer Diet: animal fat, red meat and salt-cured or smoked foods Tobacco and alcohol Crohn’s disease Celiac disease S.I. ADENOCARCINOMA Epidemiologically, small-bowel adenocarcinomas have a striking resemblance to large-bowel adenocarcinomas: 1. They share a similar geographic distribution. 2. They tend to co-occur in the same individuals, with an increased risk of SI adenocarc