## Gastric Carcinoma Histological Classification **Key Point:** Gastric carcinoma is classified into two main histological types based on the Lauren classification, which has significant prognostic implications. ### Lauren Classification | Feature | Intestinal Type | Diffuse Type | |---------|-----------------|---------------| | **Growth pattern** | Cohesive, glandular | Infiltrative, scattered | | **Cell morphology** | Columnar, mucin-secreting | Signet-ring cells, poorly differentiated | | **Prognosis** | Better | Worse | | **Metastasis pattern** | Lymph nodes, liver | Peritoneal, diffuse | | **Associated factors** | H. pylori, intestinal metaplasia, chronic gastritis | Genetic predisposition, hereditary diffuse gastric cancer (CDH1 mutation) | | **Age at presentation** | Older (55–60 years) | Younger (40–50 years) | | **Stage at diagnosis** | Often advanced | Usually advanced | **High-Yield:** The diffuse type (signet-ring cell carcinoma) has a 5-year survival rate of ~10–15%, compared to ~30–40% for intestinal type, because it: - Infiltrates the submucosa and muscularis propria early - Spreads to peritoneum and distant organs - Is often diagnosed at stage III–IV **Clinical Pearl:** Signet-ring cells are characterized by a large vacuole of mucin that displaces the nucleus to the periphery, giving a "signet-ring" appearance on histology. **Mnemonic:** **DIG** = **D**iffuse type = **I**nfiltrative = **G**rim prognosis.
Sign up free to access AI-powered MCQ practice with detailed explanations and adaptive learning.