#drsanjeevchitragar #weeklyrevision7 #controversy #pathology #GITagain these are controversial

otherwise main reference is robbins seconded by DeVita ,WHO book for GI tumors and other GI
pathology books
1.MC tumor of appendix is CARCINOID
Although the new hypothesis is ovarian mucinous carcinomas are secondary from appendix (this
hypothesis is not accepted fully as of now... and one of the book clearly nailed it saying "carcinoid
are MC primary tumors of appendix followed by mucinous tumors)
Don't confuse MC site of carcinoid is not appendix its ileum (this does not change the fact that MC
tumor of appendix is carcinoid)
2. MOST important prognostic feature of colonic carcinoma is depth of invasion followed by
lymphnode status (this is true for esophagus and gastric ca as well)
Robbins 9th ed of 813 "two most important prognostic factors are depth of invasion and lymphnode
Mets. Invasion into muscularis propria confers significant reduced survival that is decreased further
by lymphnode Mets "
3 MC site of MALTOMA is stomach (not ileum where MALT is more ... in contrast MALTOMA are not
common in MALT containing tissues (pg 773)
4 MC site of lymphoma in GIT is stomach (remember stomach is MC extranodal site for lymphomas )
5 MC lymphoma of stomach is MALTOMA (not DLBCL)
6 MC lymphoma of intestine is DLBCL
MC site of lymphoma in intestine is ileo cecal
7MC mesenchymal tumor of stomach is GIST (NOT LEIOMYOMA )
In fact GIST is also MC mesenchymal tumor of abdomen

since there has been lot of controversy on this subject I am quoting the WHO book on lymphoma
and leukemia (which is the book followed by all)
MC leukemia in DS IS AML (Not ALL as given in some books)
Two clear sentences from WHO BOOK to substantiate answer (p 142 and 143)
--ration of ALL to AML IS 1:1.2 IN DS as compared to 4:1 in non down syndrome patients
--AML usually acute megakaryoblastic leukemia accounts to 50% of all leukemia in children of DS
MC type is AML M7 (70% of AML are AML M7)

Myeloid sarcoma or granulocytic sarcoma or chloroma markers in decreasing order

CD68MPOCD117CD99LYSOZYMEcd34
I will be updating few more controversial topics in coming days

#drsanjeevchitragar #weeklyrevision6 #carcinoid #controversy

#pathology #oncology
Again lot of controversies regarding this topic between Robbins and Harrison's the 9th edition of
Robbins clears all controversies (may be authors are following questions asked in Indian exams)
1.MC site of carcinoid overall in body GIT (ileum) tracheobronchial
2.MC site in GIT- midgut ileum followed by appendix and colorectal
3.MC cause of carcinoid syndrome GIT (ileal)
Remember both GI and tracheobronchial have ~10% chances of carcinoid syndrome obviously
incidence wise GI are more so MC cause of carcinoid syndrome is GIT (ileum) (although first pass
metabolism occurs but these have high tendence to Mets thus syndrome
4. Most important prognostic feature of carcinoid is SITE (midgut carcinoid- jejunum ileum are most
aggressive and have worst prognosis ) followed by foregut carcinoids (gastric)
5 bronchial & hind gut (appendix and colorectal) Carcinoids rarely metastasise and have good
prognosis