Esophageal and Gastric Pathology Flashcards
What lines the fetal esophagus?
Ciliated epithelium.
What is an esophageal duplication cyst, and why do they matter?
There’s a second, blind out-pouching of esophagus. Food sits there and rots -> bad breath and increased risk of squamous cell carcinoma.
What is an inlet pouch? Importance?
It’s a remnant of cliated epithelium in the esophagus. It’s completely benign.
What does it mean to have inflammation of the esophagus? (i.e. what cells?)
Neutrophils and eosinophils.
Lymphocytes are normal.
What should you think if you see ulcers / other lesions on the esophagus that don’t start at the GE junction?
The etiology is something other than reflux.
2 viruses that can cause esophagitis in immunocompromised patients?
Herpes
CMV
What does candida esophagitis look like grossly? On histology?
“Cheesy” white plaques grossly.
Histologically: keratin debris with yeasts and pseudo-hyphal forms.
What is a Schatzki ring?
Muscular ring covered by squamous epithelium - common cause of dysphagia.
(treatment = dilation
Is achalasia classified as hypo or hypermotility?
Hypermotility, actually, because early in disease there’s lots of contraction as esophagus tries to get stuff past the LES.
Later on, the esophagus gives up.
What muscle cell layer atrophies in scleraderma?
The inner circular muscle layer atrophies.
What is a Mallory Weiss tear?
Longitudinal tear caused by repeated wrenching vomiting.
causes lots of bleeding, esp. in a background of alcoholic liver disease - less clotting factor production
How do esophageal and gastric cancers compare in incidence to colo-rectal cancer? In lethality?
Esophageal and gastric cancers are less common, but more lethal when they happen.
What’s the most common esophageal malignancy in the world? In the US?
World: Squamous cell carcinoma.
US: Adenocarcinoma.
What type of cell do you see in Barrett’s esophagus that you really shouldn’t see there?
Goblet cells (should only be in the intestine)
Take home points about the length of the lesion in Barrett’s esophagus?
Length is fixed at the time of injury (it doesn’t grow or regress).
Longer metaplastic region is associated with greater risk of cancer.
How does glandular mucosa look different from squamous mucosa, grossly, in an esophagus?
Squamous is white.
Glandular is salmon-colored.
Is HPV a risk factor for squamous cell carcinoma of the esophagus?
Nope.
Risk factors for squamous cell carcinoma of the esophagus? (6 are listed)
EtOH, smoking, moldy foods, achalasia, lye ingestion, diverticulum.
What’s a benign tumor of squamous epithelium?
Papilloma.
this is related to HPV infection - carcinoma in the esophagus is not
What’s glycogenic acanthosis?
A benign growth of glycogenated squamous mucosa.
What’s a name for the area of the stomach that makes acid, pepsin, intrinsic factor aside from “corpus/fundus”?
The oxyntic region.
Acute gastritis is mainly a product of…?
Barrier breakdown -> acid and pepsin gets to epithelium -> bleeding and inflammation.
Etiologies of acute gastritis? (6 are listed)
Alcohol Severe stress (including head trauma, burns) Shock Radiation Caustic agents NSAIDs
What pills are particularly caustic when they get stuck in one’s throat?
Iron pills
