GI Pathology: Gupta Flashcards
What is sialadenitis?
Etiologies?
Clinical manifestation?
inflammation of salivary glands
Infectious, Sjogren’s syndrome, sarcoidosis, irradiation
Staph. aureus- MCC (pathogen)
Typically involves parotid- swollen and painful. Duct drains pus.
Hairy leukoplakia: Cause- Appearance- Associations- Malignant? Premalignant? Not premalignant?
Cause- EBV
Appearance- white plaque that cannot be scrapped off- unlike thrush
Association- AIDS, immunosuppression, old age
Considered premalignant until proven otherwise.
Erythroplakia Cause- Appearance- Male or female predominance? Malignant? Premalignant? Not premalignant?
Cause- tobacco use
Appearance- erythematous, level or slightly depressed from surrounding mucosa
Found in men, predominately
90% are severely dysplastic, CIS, or minimally invasive carcinoma
Approx 95% of cancers of the head and neck are adenocarcinomas, SCC, gangliomas…?
What is the etiology in 70% of cases?
SSC
70% are secondary to HPV-16
Whereas SCC due to smoking is associated with mutated ____, HPV related SCC is due to mutations in ____.
p53 (smoking)
p16- cyclin-dependent kinase inhibitor (HPV)
A pt with HPV negative or HPV pos. SCC has a better prognosis?
HPV positive
What is a dentigerous cyst?
Cure?
Cancer association?
A cyst originating around the crown of an unerupted 3rd molar. Lined by SS epith.
Removal of lesion is curative.
Associated w/ ameloblastoma*- locally invasive tumors in mandible, radiolucent “soap bubble”
*Ameloblasts are cells present only during tooth development that deposit tooth enamel, which is the hard outermost layer of the tooth forming the surface of the crown. -Wiki
What is an odontogenic karatocyst aka karatocystic odontogenic tumor?
How old/what sex are the pts?
What area of the mandible are they found in?
Radiographic and histo appearance?
Cure?
Rare and benign but locally aggressive developmental cystic neoplasm. It most often affects the posterior mandible.
Males 10-40yo
Posterior mandible
Rad- well-defined unilocular or multilocular radiolucencies
Histo- Cyst lined by thin layer of keratinized SS epith. w/ a prominent basal cell layer and corrugated epith.
Resect lesion for cure. Inadequate resection results in 60% recurrence.
What is a cholesteatoma?
Non-neoplastic cystic lesions lined by karatinizing SS epith. or metaplastic mucus secreting epith. Filled with amorphous debris.
Kind of like an epidermal inclusion cyst of the ear. Can cause local destruction of middle/inner ear.
Cyst on later aspect of neck along SCM. What is it?
What’s found in it, histologically?
Brachial cleft cyst.
Prominent lymphoid cells on histo (germinal centers)
Cyst along midline of neck. What is it?
What is found in it on histo?
Thyroglossal duct cyst.
Find lymphoid aggregates or remnants of recognizable thyroid tissue on histo
What combination of fistula/atresia/blind endedness is the most common presentation of esophageal malformation?
Blind ended proximal esophagus w/ distal esophageal fistula to trachea. Air down trachea—> into esophagus —> stomach
A posterior outpouching of mucosa and submucosa of the esophagus through the cricoharyngeal muscle is called a:
Zenker (pharyngeal) diverticula
longitudinal mucosal tears near the gastroesophageal junction are called:
Mallory-Weiss tears. Often present as blood in vomit.
Difference between omphalocele and gastrochesis?
Omphalocele has serous parietal peritoneum surrounding it. Basically, guts in a bag protruding from abdomen. Due to abd. muscles not coming together appropriately.
Gastrochesis has no parietal peritoneum. Just guts protruding from abdomen.
Meckel diverticulum is a failed involution of the:
Explain the “rule of 2s” as it relates to MD.
They often become symptomatic because of:
Vitelline duct
2% of population present within 2 ft of iliocecal valve 2 inches long x2 more common in males symptomatic by age 2, if ever. only 4% ever symptomatic
Often symptomatic due to presence of ectopic pancreas, secreting enzymes that cause damage–> inflammation
Pyloric stenosis: Cause? Presentation? males/females? Physical exam findings?
Hypertrophic pyloric circular muscle
Projectile vomiting.
Males
Firm, ovoid 1-2cm abdominal mass
Esophageal mucosal webs.
Syndrome name?
Men or women?
Associations?
Patterson-Brown-Kelly or Plummer-Vinson syndrome
Women.
Assoc. w/ Fe deficiency anemia, dysphagia from incompletely chewed food.
Fe def—> angular cheilitis, glossitis.
What are Schatzki rings?
Like an esophageal web but circumferential as opposed to sectional.
Viral esophagitis:
Viral etiologies?
Histo appearance?
Gross appearance?
HSV, CMV
Multinucleated giant cells with viral inclusions
Overlapping herpetic ulcers in distal esophagus.
Fungal infxn of the esophagus. What is causing it?
Candida- big sign: parakeratosis
What will you see histologically in graft-versus-host dz?
Dyskeratotic/dying keratinocytes in mucosal epithelium +/- lymphocytic inflammation
Ulcers occurring in the proximal duodenum associated with severe burns or trauma (skin burns/trauma, not to GI tract, necessarily) are called:
Curling ulcers (think curling iron burn)
Gastric, duodenal and esophageal ulcers in pts with intracranial dz are called:
These carry a high incidence of:
Cushing ulcers
High incidence of perforation
Gastric antral vascular ectasia aka watermelon stomach: Cause? Gross appearance on endoscopy? Histo appearance? Dz associations? Presentation?
Cause: ectatic mucosal vessels
Longitudinal stripes of edematous, erythematous mucosa that alternate with less severely injured, paler mucosa (hence, watermelon stripes)
Histo: reactive gastropathy w/ dilated capillaries containing fibrin thrombi
Dz assoc: cirrhosis and systemic sclerosis
Presentation: occult fecal blood or Fe def. anemia
MCC of small bowel obstruction:
MCC of intestinal obstruction worldwide:
MCC of intestinal obstruction in children younger than 2yo:
Peritoneal adhesions in US
Herniation worldwide
Intussusception
Clinical presentation of intestinal obstruction:
abd pain, distension, vomiting, constipation
Graft-vs-host dz:
Cause?
Histo appearance?
Cause- hematopoietic stem cell transplantation. Secondary to donor T-cells targeting antigens on host's GI epithelial cells. Small bowel/colon involved in most cases. Mucosal apoptosis (not necrosis, bc cell mediated!)
Pure SCC of the anal canal is most freq assoc. w/:
HPV-16
MCC of acute appendicitis:
Dx requires:
Overt lumenal obstruction by poop stone aka fecalith.
Dx req’s neutrophilic infiltration of the muscularis propria
Most common tumor of appendix?
Benign or malignant?
proximal or distal tip assoc?
Gross appearance on cross section?
Carcinoid tumor
Almost always benign
Distal tip swelling
Well-circumscribed, golden-yellow color.
Mucinous neoplasms of the appendix:
Types?
Clinical course?
Prognosis?
Can be mucocele- a dilated appendix filled with mucin (indolent)
Can be a mucinous cystadenoma or cystadenocarcinoma.
Cystadenocarcinoma can invade through wall of appendix and spread intraperitonealy (pseudomyxoma peritonei).
Can be held in check for yrs by debulking but in most instances, is fatal.
