103b esophagus pathology Flashcards
dyspagia
difficultly swallowing
odynophagia
painful swallowing
dyspepsia
indigestion
esophagus cell type and basal layer thickness
non-keratinized stratified squamous epithelium
15% (<50% for papilla)
where are glands and lympahtics located in the esophagus?
submucosa
what is the z line?
GE junction b/w columnar epithelium of stomach and non-keratinized statified squadmos epi of esophagus
which is darker staining in the esophagus - smooth or skeletal muscle?
skeletal is darker
reflux esophagitis definition
inflammatory process
reflux of gastric/dueodenal contents
failure of anti-reflux mechanisms (not belching or vomiting)
predisposing factors for RE
symptoms of PE
hiatus hernia
pyloric stenosis
increased intraabdominal P
symptoms - heart burn, painful swallowing, bleeding
RE pathogenesis and complications
low LES tone
increased gastic empting time
antral gastritis
complications - ulcers, strictures, barrett’s esophagus
RE endoscopic findings
nothing 50% of time
hyperemia
white plaques from keratin formation
RE histo
basal cell hyperplasia
vascular papillae extension to surface
inflam. cels (PMNs, eosinophils)
Eosinophilic esophagitis morphology
> 15 intraepithelial eosinophils in 2 or HPF
25 in any HPF
lamina propria fibrosis
EoE presentation
majority have dysphagia with food getting stuck due to muscle dysfunction as a result of lamina propria fibrosis
EoE treatment
removal of allergic etiology
steroids
barrett’s esophagus definition
replacement of nonkeratinized (stratified) squamous epithelium with intestinal (nonciliated columnar) epithelium and goblet cells in the distal esophagus
BE pathogenesis
GERD leads to ulcers which is replaced by stem cells turning into wrong type of cells
BE complications
adenocarcinoma (glandular differentiation) in the distal esophagus
what are the malignant cancers of the esophagus for the epithelium and mesenchyme
epi - adenocarcinoma and squamous cell carcinoma
mesen - leiomyosarcoma
what is the most common esophagus cancer in US? world? Where do these present?
US - adenocarcinoma (lower 1/3)
world - squamous cell (upper 2/3)
Plummer-vinson syndrome
long term iron deficiency
dysphagia due to web-like memrbanes in upper esophagus
tumor classification for esophagus
t1 = submucosa t2 = muccularis propria t3= adventitia t4= adjacent structures
