CAM202 Path Pots Flashcards
Squamous Cell Carcinoma of the Buccal Mucosa
Pleumorphic Adenoma of the Parotid
Oesophageal Varices
Chronic Oseophagitis
(active, with scarring)
Reflux oesophagitis*
Squamous Cell Carcinoma of the Oesophagus
Chronic Gastric Ulcer
Leather Bottle Stomach
Strikingly thickened stomach wall - loss of plasticity
(secondary to a plaque-like tumour involving the entire mucosal surface and infiltrating through the muscular layers and into the serosal tissues)
Adenocarcinoma of the stomach
Adenocarcinoma of the Stomach
+ microscopically?
Perforated Pre-Pyloric Gastric Ulcer
4 zones of chronic gastric ulcer:
- Thin Layer of Necrositc Debris
- Non-specific Inflammatory Cell Infiltrate
- Granulation Tissue
- Scar Tissue beneath the granulation tissue
Squamous Cell Carcinoma of the Tongue
The specimen includes: sagitally sliced tongue, epiglottis, larynx, and upper trachea & bit of upper oseophagus
Tumour extends through tongue and into the hyoid bone
Does not invulve the epiglottis
Pleumorphic Adenoma of the Parotid
Encapsulated oval shaped tumour mass from the parotid salivary gland
Oesophageal Varices
In the lower part of the oesophagus, there are distended, congested venous channels underlying the oesophageal mucosa
Squamous Cell Carcinoma of the Oesophagus
Shows a segment of oesophagus encircled with tumour mass 5cm in length that shows ulceration
Grey-white tumour tissue has infiltrated the entire thickness of the oesophagus wall
+ Microscopically?
Chronic Gastric Ulcer
Four zones of a chronic ulcer:
- Thin layer of Necrotic Cellular Debris
- Non-specific Inflammatory Cell Infultrate
- Granuluation Tissue
- Scar Tissue (lying beneath the granulation tissue)
*Surrounding mucosa exhibits some intestinal metaplasia and inflammatory vhanges - mild atropic gastritis
+ Microscopically
Miltiple Perforated Gastric Ulcers
Stomach has been opened to demonstrate the two ulcers which are both adjacent to the Lesser Curvature
Four zones of chronic ulcers:
- Thin layer of Necrotic Cellular Debris
- Non-specific Inflammatory Cell Infiltrate
- Granulation Tissue
- Scar Tissue (unerdlying the granulation tissue)
Leath Bottle Stomach
Specimen = part of the stomach showing grossly thickened walls. Grey white tumous tissue extends through the muscular layer and into the serosal tissue.
Loss of normal Rugal pattern of the mucosa
This has produced the rigid thickening of ‘leather bottle’
Adenocarcinoma of the Stomach
This specimen = posteror wall of the stomach and the pre-pyloric region
Fungating tumour 6cm in diameter situated mostly in the lesser curvature and the upper part of the posterior wall
+ microscopically?
Crohn Disease
Specimen = terminal ileum and caecum w/ appendix
Ileal mucosa has irregular polypoid appearance with elongated ulcers in the proximal portaion
Wall of the ileum is grosly thickened and the lumen is narowed
Serosal surface shows marked focal congestion in the area relating to the fistula track
Caecum and appendix are macroscopically normal
Microscopically:
- Chronic Mucosal Damage
- Transmural Inflammation
- Focal Non-Caseating Granulamata
- Fibrosis
- Knife-like clefts lined with granulation tissue (suggestive of active disease)
+ Histologically
Acute Supporative Appendicitis
Enlarged, swollen appendix with a thickened, congested wall
Fibrinous Exudate covers Serosal Surface
Faecal Concretion is Impacted in the Proximal part of the Lumen
Distal Appendix = dilated with pus
Microscopically:
- All layers neutrophil infiltration
- Fibrinous inflammatory exudate coating the serosa
- Oedema
Acute Gangrenous Apendicitis
Specimen = appendix with fatty mesoappendix
Serosal surface is partly covered in a grey-rellow fibro-purulent inflammatory exudate
Appendiceal tip shows congestion and dark necrotic tissue
+ Histologically
+ common causative organism
Pseudomembranous Colitis
Specimen = two short lengths of opened bowel
Mucosal surface of colon is studded by multiple pale yellow plaques up to 5mm in size
Interventin mucosa appears normal
Muscle and serosal layers are normal
Microscopically:
- Multiple foci of ulceration
- Gland crypts in foci of ulceration are distended by muco-purulent exudate
- Fibrin and neutrophil admix that errupts from the glands forms the ‘pseudomembranes’
Cause
Often post-Abx therapy, and caused by clostridium difficile
+ Microscopically
Ulcerative Colitis
Specimen = opened segment of colon
Mucosal surface shows numeroas coalescent areas of ulceration. Between areas of ulceration appear to by islands of regenerating mucosa (appear pale and slightly protuberant) = pseudo polyps.
Microscopically:
- Intanct mucosa shows crypt abscess formation
- Areas of ulceration show:
- loss of mucosa and lamina propria; submucosa partially replaced by acutely inflamed granulation tissue
Multiple Colonic Adenomas
Specimen = section of opened bowel
Polyps are long, thin delicate projections
(unusual appearance)
Intervening Mucosa appears normal
Adenocarcinoma of Ascending Colon and Caecum
Specimen = terminal ileum, appendix, caecum and ascending colon
Tumour tissue has invaded the entire thickness of the bowel wall and is invading the pericolic adipse tissue
Small abscess is present within the tumour on the lateral side of the bowel*
Diverticular Disease of the Colon
Numerous outpouchings alligned with the margins of the Teniae Coli
From the mucosal surface, numerous flask-shaped outpouchings, lined by mucosa, extend into the muscularis propria of the bowel
Diverticulae have thin walls - attenuated or absent muscularis propria
Adenocarcinoma of the Rectum
Specimen = Sigmoid Colon, Rectum, Anus and Peri-anal skin
Large, ulcerated and fungating tumour mass with villous sirface is in the rectum
Tumour has extendend through the muscle layer and into the peri-rectal fat at the back of the specimen
+ Histologically
Chrons Disease of the Terminal Ileum
Specimen = ~45cm of terminal ileum, the caecum and !20cm of colon
Loops of small bowel are adhered to one another
Ileo-colic fistula is present
Most of the ileal wall is markedly thickened with narrowed lumen
Normal mucosa has been replaced by flattened granular mucosa with longitudinal zones of ulceration
Creeping fat wraps around the bowel surface
Microscopically:
- Chronic mucosal damage
- Ulceration
- Mucosal Atrophy
- Heavy plasma cell infiltrate
- Non Caseating granulomatas
- Transmural inflammation