GIT - oral cavity Flashcards
diseases of oral cavity (3)
- inflammations - HSV, HFMD, candida
- oral ulcers
- neoplasms: leukoplakia, squamous cell neoplasm
causes of mouth ulcers
- list 3
- trauma
- recurrent aphthous ulcers
- infection: HSV, candidiasis, HFMD
- blood disorders
- GIT disorders
- mucocutaneous
- cytotoxic chemotherapy
- neoplasms
aphthous ulcers
- what is it
- age group it affects
superficial ulceration of oral mucosa
recurrent
most common <20yrs
resolves by itself
leukoplakia (neoplasm)
- what is it (colour)
white patch/plaque - thickened keratotic hyperplastic mucosa
- cannot be scrapped off
5-25% precancerous
erythroplakia (neoplasm)
colour
complication
red area in the mouth
high risk of malignant transformation
differential diagnosis of white plaque like leokoplakia
- candidiasis
- lichen planus: chronic inflammation - sores can be white/red, burning pain
tumours of oral cavity (oropharynx) (5 cell types affected)
- squamous epithelium
- glandular epithelium
- soft tissue
- melanogenic system (melanocytes)
- unclassified
neoplasm arising from squamous epithelium
squamous cell papilloma
HPV neg SCC
HPV pos SCC
squamous epithelium papilloma
- cause
- gross and microscopic appearance
most common benign epithelial neoplasm
may have HPV
- exophytic, warty, cauliflower looking lesions
- micro: papillary projections of fibrovascular core on ss epithelium
HPV neg SCC affects what age range which part does it affect association complications
males (50-70) most common on the lips - gum - tongue associated w/ leukoplakia w/ dysplasia well-differentiated and keratinising local infiltration/ metastasis to neck lymph nodes
HPV pos SCC
affects who more
risk factor
prognosis?
better prognosis that HPV neg SCC
risk factor: oral sexual contact
young Caucasians w/ high socioeconomic status
salivary gland diseases
- inflammation - mumps, s.aureus, s.viridans, SJS (autoimmune)
- sialolithiasis (salivary gland stones)
- neoplasms
salivary gland neoplasms
- examples of benign and malignant
- which gland is most commonly affected
parotid gland most commonly affected > submandibular
most neoplasms in salivary gland are benign
- pleomorphic adenoma (most common)**
- warthin tumour
malignant tumours:
- mucoepidermoid carcinoma
- adenocarcinoma
smaller tumours are likely to be more malignant
pleomorphic adenoma
- most likely to affect what area
- characteristics
- removal
- malignancy
- 2 components
benign most common in parotid painless, slow-growing prone to recurrence - no true capsule, need to remove entire tumour but unlikely to turn malignant
- epithelial component
- myoepithelial: cartiligenous - micro: produce lobules of cartilage
Warthin tumor
- who it affects
- where it affects
- macroscopic and microscopic tumours
benign
super common in SG: 2nd
happens in parotid gland
males (50-70yrs)
macro: oval, round encapsulated mass
micro: double-layer of epithelial cells, dense lymphoid stoma w/ germinal centres
esophagus diseases (5)
- congenital: atresia (the esophagus got blocked midway), tracheo-esophageal fistula
- motor dysfunction: achalasia (lower esophagus cannot open during swallowing), hiatus hernia
- esophageal varices
- esophagitis
- neoplasm
esophageal varices cause
portal HTN (high BP in portal vein) -> buildup of blood near esophagus -> cause the vessels to dilate
hiatus hernia
cause
+ complications (4)
reflux esophagitis (heartburn) caused by weakness in the diaphragm -> herniation through when stomach pushes upwards
effects:
- peptic ulceration
- dysphagia (cannot swallow), caused by sclerosis and stricture of the esophagus
- columnar metaplasia = Barrett esophagus - cause of gastric reflux -> damage the epithelium, esophagus undergoes change in epithelium (stratified squamous -> simple columnar)
- dysplasia: adenocarcinoma
esophagitis causes (4)
- reflux: GERD** (gastroesophageal reflux disease) & barrett esophagus
- infection: HSV, CMV, candida, bacteria, parasites
travelled downwards from oral infection - drugs/toxins
- cytotoxic chemotherapy/ radiation
GERD (gastroesophageal reflux disease)
- what increases risk of getting GERD
- clinical presentation
- characteristics: macro + micro (4)
most common cause of esophagitis
caused by: lower esophageal sphincter unable to close completely -> allows gastric acid to go up the esophagus -> epithelial wall secrete inflammatory cells
- age, BMI, tobacco increases risk
- more prevalent in the west
clinical presentation: heartburn, acid regurg, sore throat, cough
characteristics: - erosions, strictures - micro: basal zone hyperplasia, inflammatory cells (lymphocytes, eosinophils), elongated lamina propia papillae, polymorphs
barrett esophagus
- characteristics
- effects
- diagnosis
squamous -> columnar epithelium
w/ red mucosa
causes ulceration/ bleeding/ stricture/ dysplasia
may form adenocarcinoma
diagnosis: columnar epithelium above GE junction
intestinal metaplasia - goblet cells in esophagus
neoplasms in esophagus (3)
- SCC
- adenocarcinoma
- leiomyoma
SCC in esophagus
- age group it affects
- risk factors
affects older male group
increased risk w/ alcohol, tobacco, nitrites, nitrosamines, poverty, achalasia
SCC in esophagus
- invasive?
- which part does it affect
invasive
more common affecting middle 1/3 of esophagus - mediastinal group