Question

What are the differences between peptic ulcer of the stomach and gastric carcinoma in gross view?

Answer 1

Peptic ulcer is usually solitary, round or oval, small and has a punched out appearance. The depth varies from being superficial to deep. Majority ulcers are benign and has flat margins in level with the surrounding mucosa. Malignant gastric ulcers are large and bowl shaped with elevated and indurated mucosa at the margins.

Gastric carcinoma is of two types- early gastric carcinoma and advanced gastric carcinoma. Early gastric carcinoma may have three patterns: polypoid, superficial and ulcerated. Advanced gastric carcinoma can have five patterns: ulcerative, fungating (polypoid), scirrhous, colloid (mucoid) and ulcer cancer. In ulcerative pattern, tumor appears as a flat, infiltrating and ulcerative growth with irregular necrotic base and raised margin. Polyploid pattern is a cauliflower growth projecting into the lumen. Scirrhous pattern has thickened stomach wall due to extensive desmoplasia. Colloid pattern is seen in the fundus as a gelatinous mass with large quantities of mucus. Ulcer type develops from chronic gastric ulcer and is a rare occurrence.