Exam 1 Path: GI Path (morphology, tables, key concepts) Flashcards
Eosinophilic intranuclear viral inclusions
Fusion of affected cells to form giant cells (multinucleate polykaryons)
Diagnostic Tzank test
HSV infection
Pseudohyphae
Budding yeast
Pt is immunocompromised, DM, on abx, oral steroids
Candida infection
Raspberry tongue (firey red with prominent papillae)
Strawberry tongue (white tongue with red papillae)
Scarlet fever (GAS)
Spotty erythema of the oral cavity that precedes skin rash
Ulcerations of buccal mucosa (koplik spots)
*unvaccinated child
Measles
Pharyngitis and tonsilitis that may be exudative
Enlarged cervical LNs
Palatal petichiae
Mono (EBV)
Dry white tough fibrosupprative membrane over the tonsils/retropharynx
*unvaccinated
Diptheria
Oral candidiasis
Kaposi sacroma
Hairy leukoplakia
HIV
White, raised verrucous plaque
Hyperkeratosis, acanthosis, balloon cells
Dysplastic mucosal epithelium
Hairy Leukoplakia (on lateral tongue)
Leukoplakia (anywhere in mouth)
Red, velvety area within oral cavity
Severe dysplasia/carcinoma in situ/carcinoma
May be caused by subepithelial inflammatory rxn
Erythroplakia
Head and neck cancer
E6 and E7 inhibit Rb and p53
p16 overexpression
white, non-smoking male
HPV OPSCC
Head and neck cancer
Tobacco carcinogen induced DNA damage
Mutations possible in *tp53, CDKN2A, PIK3CA, NOTCH1, FAT1, Cyclin D1, tp63
Classic OPSCC
Salivary gland tumor
Benign
well demarcated mass with epithelial and mesenchymal elements
PLAG1 rearrangements or HMGA2 mutations
Pleomorphic adenoma
Salivary gland tumor
Benign
Almost exclusively in parotid gland
Smokers
Epithelial and Lymphoid elements
Warthin tumor
Salivary gland tumor
Malignant
Mostly in parotid gland
Cords and sheets of squamous and mucus cells
t(11:19) creates fusion gene MECT1-MAML2
Mucoepidermoid carcinoma
Salivary gland tumor
Malignant
Half occur in minor salivary glands
Grow along nerves so painful
MYB-NFIB gene rearrangements
Half spread to brain/bone/liver
Swiss cheese on histo
Adenoid cystic carcinoma
Most common congenital GI intestinal atresia
imperforate anus
TE fistulas occur during what weeks of embryo development
4-5
Congenital Functional obstruction of the colon
NCC migration failure
Rectum always involved
Obstruction proximal to aganglionic segment
Hirschprung
Hypertrophic gastropathy
cerebreform rugae
hypoproteinemia, weight loss, diarrhea
lots of mucus cells
some lymphocytic infiltrate
no risk factors
association with adenocarcinoma
Menetrier Dz
excess TNF-a leads to hyperplasia
Hypertrophic gastropathy
cerebreform rugae
peptic ulcers
lots of parietal cells
neutrophilic infiltrate
association with multiple endocrine neoplasia
no association with adenocarcinoma
Zollinger Ellison Syndrome
gastrinoma leads to parietal cell proliferation and increased acid
Gastric cancer
CD1H mutation (loss of E cadherin)
Litnus plastica
diffuse gastric adenocarcinoma
Gastric cancer
Loss of fx mutation in APC or gain of function in B-catenin
Most common in lesser curvature
Desmoplastic reaction makes tumor nodular
associated w/ H Pylori chronic gastritis
intestinal type gastric adenocarcinoma
Gastric cancer
t(11:18) leads to NF-KB activation
Lymphoepithelial lesions
caused by H Pylor
MALToma
Gastric cancer
mesenchymal tumor
arise from interstitial cells of Cajal (pacemakers)
cKIT or PDGFRA mutations
gastrointestinal stromal tumor (GIST)
treat with tyrosine kinase inhibitor imatinib
Severe persistent diarrhea and autoimmune dz
FOXP3 mutation, defective Tregs
X-linked
Autoimmune enteropathy
Inability to create lipoproteins
microsomal triglyceride transfer protein mutation (MTP)
AR
abetalipoproteinemia
