Most common site of gastric cancer is:

Ans: D (Antrum) Ref: Robbins Pathologic Basis of Disease, 8th edition.Explanation:"Most gastric adenocarcinomas involve the gastric antrum; the lesser curvature is involved more often than the greater curvature" (Ref: Robbins)Gastric AdenocarcinomaAdenocarcinoma is the most common malignancy of the stomach, comprising over 90% of all gastric cancers.Early symptoms are non-specific and resemble those of chronic gastritis, including dyspepsia, dysphagia, and nausea.Weight loss, anorexia, altered bowel habits, anemia, and hemorrhage manifests in advanced stagesAs a result, these tumors are often discovered at advanced stagesMorphologyMost gastric adenocarcinomas involve the gastric antrumThe lesser curvature is involved more often than the greater curvatureGastric tumors are divided into two major types based on morphologyIntestinal typeDiffusi ve tnfil trative typeTumors with intestinal morphology tend to form bulky tumors composed of glandular structures while cancers with a diffuse infiltrative growth pattern are more often composed of signet-ring cells Intestinal-type adenocarcinomas typically grow along broad cohesive fronts to form either an exophytic mass or an ulcerated tumor.The neoplastic cells often contain apical mucin vacuoles, and abundant mucin may be present in gland lumens.Diffuse gastric cancer is generally composed of discohesive cells that do not form glands but instead have large mucin vacuoles that expand the cytoplasm and push the nucleus to the periphery, creating a signet-ring cell morphology.Extracellular mucin release in either type of gastric cancer can result in formation of large mucin lakes that dissect tissue planes.A mass may be difficult to appreciate in diffuse gastric cancer, but these infiltrative tumors often evoke a desmoplastic reaction that stiffens the gastric wallWhen there are large areas of in titration, diffuse rugal flattening and a rigid, thickened wall may impart a leather bottle appearance termed linitis plasticaBreast and lung cancers that metastasize to the stomach may also create a linitis plastica- like appearance.Clinical CharacteristicsThe depth of invasion and the extent of nodal and distant metastasis at the time of diagnosis remain the most powerful prognostic indicators for gastric cancerIn advanced cases gastric carcinoma may first he detected as metastases to the supraclavicular sentinel lymph node, also called Virchow's node.Gastric tumors can also metastasize to the periumbilical region to form a subcutaneous nodule, termed a Sister Mary Joseph nodule.Local invasion into the duodenum, pancreas, and retroperitoneum is also characteristic.