Gastro Pathology Flashcards
most common Candida infection of oral cavity
Pseudomembranous (thrush)
submucosal nodular fibrous tissue mass formed when chronic irritation results in reactive connective tissue hyperplasia - most often buccal, along the bite line
Fibroma
– pedunculated mass in gingiva; dense proliferation of immature vessels similar to granulomas dense fibrous masses or peripheral ossifying fibroma
Pyogenic granuloma
term for lesion of oral cavity w/ uknown etiology, all must be considered pre-cancerous (hyperkeratosis, dysplasia)
risk factors - alcohol & tobacco
Leukoplakia
red, eroded region of mucosa with increased rate of malignancy
Erythroplakia
most common inflammatory lesion of the salivary glands – block or obstruction of salivary gland duct
Mucocele
viral sialadenitis
mumps, parotid gland
Bacterial sialadenitis
submandibular glands, Staph aureus & Strep viridans (commonly preceded by sialolithiasis)
60% tumors in the parotid gland- contains myxoid, hyaline, chondroid, osseous tissue, over-expresses PLAG1, recur if incompletely excised; slow-growing, mix of epithelial & mesenchymal cells
Pleomorphic adenoma
most common primary malignant tumor of the salivary glands; mixture of squamous & mucus cells; aggressive tumors
Mucoepidermoid carcinoma
crown of unerupted tooth, result of degeneration of dental follicle (tissue that makes surface enamel); complete removal is curative
dentigerous cysts
posterior mandible, locally aggressive w/ a high recurrence rate (multiple can occur in patients w/ nevoid basal cell carcinoma syndrome (Gorlin syndrome)
odotogenic keratocysts
inlet patch
most frequent site of ectopic gastric mucosa is in the upper third of esophagus = inlet patch (possible to secrete acid > dysphagia)
small patches of ectopic gastric tissue in small bowel or colon may cause ulcers & bleeding
Gastric heterotropia
Most common esophageal lacerations
a/w severe vomiting; peristaltic wave a/w vomiting normally causes relaxation of esophagus, but prolonged vomitting can interfere w/ this process; pts present w/ hemetemesis – the tears are superficial and longitudinal
Mallory-Weiss tears
transmurual esophageal tears and mediastinitis – catastrophic event
Boerhaave syndrome
Barret esophagus, tobacco, obesity, raditation, whites/ M»F; incidence has increased more rapidly than for any other cancer
Esophageal adenocarcinoma
a/w alcohol, tobacco, very hot beverages, more common in rural areas, more common in blacks, HPV linked in his risk areas
Squamous Cell Carcinoma of the Esophagus
transient mucus inflammatory process that may have varying degree of epigastric pain, N/V
Acute Gastritis
most common cause is H pylori, antral gastritis w/ high acid production despite low gastrin levels; urease allows H pylori to generate ammonia from endogenous urea, elevating pH around the organism, toxins like CagA involved in cancer development; deep inflammatory rxn in gastric glands/ induced mucosa-associated lymphatic tissue (MALT) can transform to lymphoma
Chronic Gastritis
second most common cause of chronic gastritis,
Autoimmune Gastritis
H pylori & NSAIDs; imbalance between mucosal defense and damaging force (same as chronic gastritis); 4x more common in proximal duodenum than the stomach; epigastric burning, worse 1-3 hours after meals, at night, relieved w/ alkali/ food
PUD
75% gastric polyps
inflammatory or hyperplastic polyps
sporadic in people w/ familial adenomatous polyposis (FAP), no neoplastic potential, increased w/ PPIs due to increased gastrin secretion due to elevated pH
Fundic gland polyps
much more common in Japan due to smoked meats, but has dropped by 85% in US due to better food handling; loss of E-cadherin function, key step in the development of diffuse gastric cancer
Gastric Adenocarcinoma
Diffuse Gastric Cancer – signet cell; desmoplastic reaction that stiffens the wall of the stomach to form …..
linitis plastica
bulky, glandular (mostly decreased in this type) – a/w atrophic gastritis, intestinal metaplasia
Intestinal Gastric Cx
small polyploid lesions desmoplastic kink / obstruct bowel; can secrete vasoactive substances (most important indicator of prognosis is location)
Carcinoid Cx
Foregut carcinoid tumor – esophagus to duodenum proximal to the ligament of Treitz; gastrinomas a/w PPIs
Midgut carcinoid tumor- jejunum & ilium, tend to be aggressive & multiple
Hindgut – rectal, more likley to produce polypeptide hormones, only occasionally metastasize
most common mesenchymal tumor of the abdomen, most occur in the stomach (GOF in c-KIT)
Gastrointestinal stromal tumor (GILT)
mildly decreased UDP-glucuronyl transferase, elevated indirect bilirubin
Gilberts
Absent UDP-glucuronyl transferase, lethal
Grigler-Najjar syndrome type I
conjugated hyperbilirbinemia due to defective liver excretion, black liver
Dubin-Johnson
milder defect in excretion/uptake of bilirubin
Rotor’s
