Histopath - Upper GI

Question 1

What cells do you find in oesophagus?

Answer 1

Submucosal glands

No goblet cells

Question 2

What cells do you find in body and fundus of stomach?

Answer 2

• Simple columnar epithelium
  
  • Produce acid & intrinsic factor

No goblet cells

Question 3

What cells are found in the pylorus and antrum of stomach?

Answer 3

Columnar epithelium and neuroendrocrine cells (produce gastrin)

no goblet cells

Question 4

What cells are found in the duodenum?

Answer 4

Columnar epithelium with goblet cells

2:1 villous:crypt ratio

Question 5

Most common type of oesophageal ca worldwide and UK

Answer 5

Oesophageal SCC

Question 6

Esophagitis

Answer 6

Redness and inflammation - neutrophils seen

Caused by GORD –> ulceration

Question 7

*Barrett’s esophagus

/pts w long term GORD

Answer 7

Squamous -> columnar

(Metaplasia)

Question 8

Goblet cells in esophagus

Answer 8

Intestinal metaplasia

Question 9

Where does SCC of esophagus occur

Answer 9

upper and middle third

Question 10

SCC of esophagus histopathology

Answer 10

Keratin and intracellular bridges

Question 11

What is SCC of esophagus associated with?

Answer 11

Smoking, alcohol and achalasia

Question 12

Where does adenocarcinoma of oesophagus occur?

Answer 12

Lower 1/3 of esophagus

Question 13

What is adenocarcinoma associated with?

Answer 13

Barrett’s disease

Question 14

What in a biopsy is indicative of H pylori infection?

Answer 14

Lymphoid follicles

Question 15

Gastritis complication

Answer 15

Mucosa associated lymphoid tissue (MALT)

Question 16

!Gastric ulcer

Answer 16

depth of the loss of tissue goes beyond the mucosa

Question 17

Gastric cancer most common type

Answer 17

Adenocarcinoma

Question 18

*Gastric ca MALT lymphoma

Answer 18

B lymphocyte driven

Question 19

Coeliac disease Ix

Answer 19

• Antibodies
• Duodenal biopsies

Question 20

Coeliac disease antibodies

Answer 20

Endomysial antibodies and tissue transglutaminase antibodies (TTgA)

Question 21

*Coeliac disease complication if not following gluten free

Answer 21

lymphoma

Question 22

When to do duodenal biosies and what will be seen?

Answer 22

• Once on gluten rich diet -> villous atrophy
• Once off gluten rich diet -> normal villi

Question 23

*Histological features of coeliac disease

Answer 23

• Villous atrophy
• *Crypt hyperplasia
• *Increased intraepithelial lymphocytes

Question 24

A 72 year old male presents to your GP surgery and complains of intermittent pain around the epigastrium. The patient looks slim with obviously loose clothing. He reports a 25 packyear smoking history. He undergoes an OGD and a biopsy of the gastric body confirms: mitotic figures, invasion of the basement membrane and signet ring cells. What is the diagnosis?

Answer 24

Adenocarcinoma

Mets from ovaries - krukenberg tumour

Question 25

*Carcinoma due to H. Pylori infection

Answer 25

Mucosa-associated lymphoid tissue (MALT) /

MALT lymphomas is associated with Chronic gastritis due to H.Pylori. t(11:18).

Question 26

*White things on the oesophagus seen in OGD of an alcoholic man with recurrent bleeding varices. What are they?

Answer 26

Oesophageal Candidiasis

Question 27

*Ca associated w coeliac

Answer 27

enteropathy-associated T-cell lymphoma (EATL)

Question 28

*What is the most common histologic type of carcinoma involving the oral cavity?

Answer 28

SCC

Question 29

*Oesophageal ca steps

Answer 29

Reactive -> metaplasia -> low grade dysplasia -> high grade dysplasia -> adenocarcinoma

Question 30

*Coeliac ix

Answer 30

Duodenal biopsy