Gastrointestinal Pathology Flashcards
What are the types of gi tract specimens
Cytology specimens
Biopsy
Surgical resection specimen
Frozen sections
What are cytology specimens
This could be oesophageal or gastric brushing
What are examples of biopsy
Endscopy biopsy
Needle core biopsy
What is a surgical resection specimen
Specimen taken out by surgery and as treatment
What are frozen sections
Specimens that are done when the patient is on the operation table, purpose is to obtain a diagnosis
What should a histopathology report inlcude
- clincal details
- gross description of the specimen
- microscopy findings
- comment, conclusion and diagnosis
Is its a small biopsy what should the gross description include
Size
Weight
If its a large biopsy what should the gross description include
Type of lesion Colour Distance to resection margin Necrosis Depth of infiltration
Which organs are involved in the upper gastrointestinal tract
- Oesophagus
- Stomach
- Duodenum
What organs does the lower gastrointestinal tract include
- small bowel
- colon
- rectum
- anal canal
What is the commonest cause of oesphagitis
GORD
What are the causes of GORD
Loss of lower oesophageal spinchter tone
Impairment of peristalsis
Delayed gastric emptying
What are the risk factors for GORD
Alcohol and tobacco use
Repeated vomiting
Nasogastric intubation
What is the difference in cell of acute and chronic oesophagitis
Acute: neutrophils
Chronic: plasma cells and lymphocytes
What is eosinophilic oesophagitis
Clinically mimics GORD and common in chidren and young adults
In histology what does eosinophilic oesophagitis show
Increased eosinophils
What is barrets oesophagus
Displacement of the normal squamous epithelium of the lower oesophagus by columnar epithelium
What is the displacement of squamous epithelium to columnar epithelium known as
Columnar metaplsia
What are the causes of columnar metaplasia
long standing reflux
What disease barrets oesophagus be associated with
Adenocarcinoma
Glandular dysplasia
What is the most common microorganism that causes gastritis
Helicobacter pylori
What are the reasons for duodenal biopsy to be performed
- inflammation
- acute inflammation i.e acute duodenitis
- parasite: giardia lamblia
What is coeliac disease
The genetic predisposition for increased immunological repsonse to gluten
What are the symptoms of coeliac disease
Diarrhoea
Weight loss
Fatigue at yougn age
Anti-tranglutaminase antibodies
On histology what is seen in coeliac disease
Partial or total villus atrophy Intra-epithelial lymphocytosis i.e incresed small lymphocytes in the epithelium Chronic inflammation Cypt hyperplasia Absence of parsites
What are the causes of ischaemia of the bowel wall
- arterial and venous impairment
- hypotension
What is seen in macrospocy in ischaemia of the bowel wall
Dilated thin congented bowel wall
Perforation
What is seen in microscopy in ischaemia of the bowel wall if acute
Ulcereation
Acute inflammation
Haemorrhage
What is seen in microscopy in ischaemia of the bowel wall if chornic
Hyalinised stroma
Scar
What is Diverticular disease
Out pouching of the mucosa and muscarlis muscosa protrufing the bowel wall
What are the common causes of diverticular disease
- reduced fibre: faecal material gets pushed into the rectum as they are hard to propel into the rectum so you get outpouching
What are complications of Diverticular disease
Diverticulitis Haemmorhage Perforation Fistula Obstruction of the bowel wall
What is crohns disease
Inflammation that can start from the mouth to the anus
What are the features of crohsn disease
Segmental
Lesions are deeper i.e can reach the subserosa
Ulcers
What are the complications of crohns disease
Intestinal obstruction Haemmorhage Anaemia Perforation Malabsorption Arthritis Dermatalogical complications
What is ulcerative collitis
Inflammation of the distal colon and rectum
What are the featues of ulcerative colitis
Continous
Ulceration
What are the complication of ulcerative colitis
Adenocarinoma Fulminant colitis Inflammation of the bile duct Cancer of the bile duct (cholangiocarcinoma) Superinfection
What is the symptom of microscopic colitis
Long standing diarrhoea
What is appendicits
Inflammation of the appendix
How do we diagnose appendicits
By the presence of neutrophils in the appendix wall
What does dysplasia mean
Presence of neoplastic cells within the epithelium
What can dysplasia progress into
Invasive carcinoma
What is a carcinoma
The neoplastic process breaches the basement membrane and invades the underlying structures
What are the 2 types of carcinoma in the oesophagus
Adenocarcinoma in barrests metaplasia
Sqaumous cells carcinoma
What are the risk factors of adenocarcinoma of the oesophagus
Barrets metaplasia due to chronic gord
Obestiy
Alcohol and tobacco use
What are th risk factors for sqamous cell carcinoma
Alcohol and tobacco use
Diet high in vegetable and fruit
Infections e.g fungal oesophagitis
Genetic abnormality: TP54 mutations
What are the risk factors for gastric adenocarcinoma
Chronic helicobacter pylori Intestinal metaplasia Hypochlorydria Lynch syndrome CHD1 mutations Exposure to rubber Tobacco use
What are the risk factors for large intestine cancer
Processed meat consumption Reduced fibre consumption Obesity Alcohol and tobacco use Medical condition: ulcerative collits, crohns disease, diabetes Decreased physical activity
What is the precursor lesion for a colorectal cancer
Adenamotous polyp (a polyp that shows dysplasia)
What is the treatment for git carcinomas
Surgical resection
Endoscoptic resention for superfical lesions
Chemotherapy
Radiotherapy
What is used to stage all GIT cancer
TNM stage
What is grading based on
- differentiation
- necrosis
- number of mitoses
Name soft tisse tumours
Gastro-intestional stromal tumours
Leiomyoma
Neuronal tumours
What are gastro-intestinal stromal tumours
Primary mesenchymal tumours thatarise on all of the GIT and are developed from the interstitial cells of CAJAL
Does ulcerative colitis or Crohn’s disease present with granuloma
Crohn’s disease
