GI Pathology - Esophagus, Stomach, Pancreas, Bowel

Question 1

GERD

Answer 1

Desquamation, elongated submucosal pegs, inflammatory cells

Question 2

Barrett Esophagus

Answer 2

Columnar with goblet cells + hyperchromatic nuclei, less goblet cells (low-grade dysplasia) + nuclear atypia, irregularity (high-grade dysplasia) + invasive (adenocarcinoma)

Question 3

Acute hemorrhagic gastritis

Answer 3

Numerous petechiae, erosions, ulcers, bigger hemorrhages

Question 4

Chronic gastritis

Answer 4

Atrophy, metaplasia, dysplasia, neoplasia, H. pylori (antrum), germinal centers

Question 5

Peptic ulcer disease

Answer 5

Small, round, deep, + punched out

Question 6

Chronic peptic ulcer

Answer 6

Necrosis, inflammation, granulation tissue, scar

Question 7

Benign ulcer

Answer 7

Round-oval, flat or overhanging margins, deep punched-out, smooth

Question 8

Malignant ulcer

Answer 8

Irregular shape, heaped-up margins, shallow sloping, necrotic shaggy

Question 9

Stress ulcer

Answer 9

Deep, single, hemorrhagic, small (< 1 cm)

Question 10

Esophageal squamous cell carcinoma

Answer 10

Aggregate with eosinophilic cytoplasm, keratin pearl, trebeculae with cell cluster around keratin pearl

Question 11

Types of esophageal squamous cell carcinoma

Answer 11

Fungating obstructive polypoid mass, diffuse circumferential thickening (napkin-ring), numerous coalescing nodules, stricture w/ hemorrhagic ulcer

Question 12

Gastric polyps - hyperplastic

Answer 12

Asymptomatic, rarely malignant, cystically dilated glands, inflamed edematous lamina propia

Question 13

Gastric polyps - fundic gland

Answer 13

< 1 cm, fundic, cystically dilated glands, oxyntic cells

Question 14

Gastric polyps - adenomatous

Answer 14

Antrum, dysplasia, crowded, hyperchromatic, glands within glands

Question 15

Gastric adenocarcinoma

Answer 15

Thickened wall, linitis plastica

Question 16

Intestinal metaplasia

Answer 16

Precursor to cancer, goblet cells

Question 17

Intestinal type adenocarcinoma

Answer 17

Varying degrees of gland differentiation

Question 18

Diffuse type adenocarcinoma

Answer 18

Signet ring cells, linitis plastica

Question 19

Metastatic gastric cancer

Answer 19

Virchow’s node, Sister Mary Joseph node

Question 20

Normal pancreas

Answer 20

Acinus, duct, islet, lobules

Question 21

Acute pancreatitis

Answer 21

Coagulative necrosis w/ ghost cells, hemorrhage, degenerating polys, necrosis between lobules

Question 22

Severe acute hemorrhagic pancreatitis

Answer 22

Brown blood, tan+yellow areas of fat necrosis

Question 23

Chronic pancreatitis

Answer 23

Dark blue dots, no acini/ducts, residual necrotic debris, early fibrosis

Question 24

End-stage chronic pancreatitis

Answer 24

Fibroadipose tissue, preservation of islets

Question 25

Cystic fibrosis

Answer 25

Severely distended, ispissated, dark pink secretions, atrophy of acini+mildly increased fibrous tissue peripancreatic lymph node

Question 26

Pancreatic carcinoma - well differentiated

Answer 26

Extensive fibrosis

Question 27

Pancreatic carcinoma - moderately differentiated

Answer 27

Poorly formed glands, back-to-back, numerous cells with huge nuclei, anaplastic cells