# Patho block V GI ## Pancreas * Serous cystic neoplasm * multicystic tumor w/ central scar, serous fluid and mostly benign nature * 胰臟尾 * 女 * Mucinous cystic neoplasm * mucinous columnar epi. w/ ovarian stroma * 囊狀空間不與胰管相通 * 胰臟尾 * 女 * Solid pseudopapillary neoplasm * Young female 女, 30 yo * CTNNB1 (b-catenin) mutation * Intraductal pappilary mucinous neoplasm (IPMN) * 胰臟癌重要前驅腫瘤 / 惡性腫瘤 * 乳突狀生長 * GNAS, KRAS, RNF43 * 胰臟頭 * 男 * Pancreatic ductal adenocarcinoma * Kras mutation (目前沒有標靶治療) * 男 = 女 * Agenesis of pancreas parenchyma * PDX1 * Hereditary pancreatitis * PRSS1: trypsin-1, when GOF (+) trypsin, 台灣最常見 * SPINK1: protease inhibitor, inhibition of trypsin, when LOF (+) trypsin * CFTR: when mutated mucous secretion blocks pancreatic duct ## Liver * Hepatocellular adenoma * HNF-1a inactivated * loss of FABP * b-catenin activated * glutamine synthase * b-catenin * @malignant tramsformation * inflammatory * gp130 mutation * CRP * SAA * unclassified ## Stomach * Diffuse type gastric adenocarcinoma: linitis plastica (皮革胃) & signet ring tumor cells * familial diffuse type gastric cancer * CDH1 (cadherin E) gene mutation * intestinal type gastric cancer * (+) wnt signaling * Ovary Krukenberg disease: gastric cancer 轉移 * GIST * Carney triad (GIST, paraganglioma, pulmonary chondroma 同時發病，好發女性) * c-KIT (CD117) (80%)/PDGFRa GOF (8%) * SDHA, SDHB, SDHC, SDHD 任一 germline mutation => Carney syndrome * DOG1 immunohistochemistry (+)