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CHAPTER 1 - LITERATURE OVERVIEW
1.1. Physiological and anatomical characteristics of the gastrointestinal tract.
The gastrointestinal (GI) tract starts from the esophagus to the end of the
anus, each segment has a different function. In addition to the special structures of
each segment, the wall of the GI tract has the same overall structure, consiting of
4 layers: mucosal layer (epithelial layer, stroma layer, mucosal layer). When the
tumor is located in different positions of the GI tract, there will be different
clinical symptoms.
1.2. Overview of clinical morphology and pathology of non-epithelial GI
cancer.
Depending on the location of the lesion at different locations of the field, the
symptoms and clinical morphology will be different, such as signs of swallowing
often found when tumors in the esophagus, intestinal obstruction is more common
in the small intestine and colon. , very rarely in the stomach, intussusception is
common when tumors in the ileum. At the same time, different types of tumors
will have different specific lesions such as GIST tumors or have high social
symptoms (stomach, jejunum), while peritonitis, intestinal perforation causes
peritonitis. Lymphoma and more often present in the ileum. According to the
latest classification of the World Health Organization, gastrointestinal tract
tumors are divided into 3 large groups: tumors of epithelial origin, tumors of non-
epithelial origin and secondary cancers. . Morphological codes according to the
international classification of disease for oncology, anatomically classifying non-
epithelial tumors of thymus include granulomatous cell tumors, GIST tumors,
smooth muscle tumors, skeletal muscle tumors, Kaposi tumors, melanoma,
lymphoma, hemangioma, adipoma, angioma, and nerve sheath tumors.
1.2.1. Malignant smooth muscle tumor (Leiomyosarcoma): Malignant smooth
muscle tumor is a type of malignant tumor of cell origin that is smooth muscle
fibers, usually occurring in middle age or elderly people. The tumor is usually
large in size, has a shell, can become a zone, a solid grayish-white density, can
progress to ulcers, alternate bleeding, necrosis. There are cases where the tumor
grows in the form of a polyp, which is stiff and infiltrated. According to Conlon,
the recurrence rate is 44% after complete resection of the tumor in an average
period of 9 months, blood-borne metastasis usually to the liver, invasiveness of
surrounding organs, rare lymphatic and elbow metastases. bad amount. With
tumors ≥ 5 cm, the survival rate over 5 years is 27% (O'Riordan et al.), If the
tumor is highly malignant, the rate of liver metastasis and recurrence also
increases as in the 17/21 field study. Collaboration by Chou et al. or other authors
also recommend that the smaller the tumor size, the lower the mitosis index, the
better the prognosis is. According to research by Rajshekar, if there is metastasis,
it is by blood sugar with 65% metastatic to liver, 15% to other part of digestive
system and 4% to lung. With the development of IHC, it is very helpful in
definitive diagnosis when positive for SMA, Desmin and H-caldesmon; negative
for CD117 and DOG1.1.
1.2.2. Malignant Lymphoma: The first malignant lymphoma (MLP) was
described by Billroth in 1871. Lymphoma in TH lymphoma accounts for 1-4% of
malignant tumors of the gastrointestinal tract, accounting for 30-40% of MLP.
