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Stomach

Carcinoma

GE junctional adenocarcinoma


Reviewers: Elliot Weisenberg, M.D. (see Reviewers page)
Revised: 22 October 2012, last major update August 2012
Copyright: (c) 2003-2012, PathologyOutlines.com, Inc.

General
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● Based on AJCC Cancer Staging Manual (7th ed, 2010), adenocarcinoma arising in gastroesophageal junction and proximal 5 cm of stomach is staged as esophageal cancer
● Heterogeneous group of tumors, but most arise from distal esophagus associated with Barrett’s esophagus; cardia adenocarcinomas and subcardial gastric carcinomas which secondarily invade GE junction also occur
Distal esophageal tumors: usually men, associated with Barrett’s esophagus (intestinal metaplasia) and reflux, less likely to have diffuse growth pattern, lower incidence of lymphatic spread, CK7+
Cardia tumors: usually men, usually not associated with Barrett’s esophagus, higher frequency of diffuse pattern, although most are still intestinal

Positive stains
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● CK7/19 (44%), CK20 (55%)

Differential diagnosis
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● Adenocarcinoma of distal esophagus: 74% are CK7+/CK20- vs. 24% of GE junctional adenocarcinomas (Am J Surg Pathol 2002;26:1213)

End of Stomach > Carcinoma > GE junctional adenocarcinoma


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