Histopath - Upper GI Flashcards
What cells do you find in oesophagus?
Submucosal glands
No goblet cells
What cells do you find in body and fundus of stomach?
- Simple columnar epithelium
- Produce acid & intrinsic factor
No goblet cells
What cells are found in the pylorus and antrum of stomach?
Columnar epithelium and neuroendrocrine cells (produce gastrin)
no goblet cells
What cells are found in the duodenum?
Columnar epithelium with goblet cells
2:1 villous:crypt ratio
Most common type of oesophageal ca worldwide and UK
Oesophageal SCC
Esophagitis
Redness and inflammation - neutrophils seen
Caused by GORD –> ulceration
*Barrett’s esophagus
/pts w long term GORD
Squamous -> columnar
(Metaplasia)
Goblet cells in esophagus
Intestinal metaplasia
Where does SCC of esophagus occur
upper and middle third
SCC of esophagus histopathology
Keratin and intracellular bridges
What is SCC of esophagus associated with?
Smoking, alcohol and achalasia
Where does adenocarcinoma of oesophagus occur?
Lower 1/3 of esophagus
What is adenocarcinoma associated with?
Barrett’s disease
What in a biopsy is indicative of H pylori infection?
Lymphoid follicles
Gastritis complication
Mucosa associated lymphoid tissue (MALT)
!Gastric ulcer
depth of the loss of tissue goes beyond the mucosa
Gastric cancer most common type
Adenocarcinoma
*Gastric ca MALT lymphoma
B lymphocyte driven
Coeliac disease Ix
- Antibodies
- Duodenal biopsies
Coeliac disease antibodies
Endomysial antibodies and tissue transglutaminase antibodies (TTgA)
*Coeliac disease complication if not following gluten free
lymphoma
When to do duodenal biosies and what will be seen?
- Once on gluten rich diet -> villous atrophy
- Once off gluten rich diet -> normal villi
*Histological features of coeliac disease
- Villous atrophy
- *Crypt hyperplasia
- *Increased intraepithelial lymphocytes
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?
Adenocarcinoma
Mets from ovaries - krukenberg tumour
*Carcinoma due to H. Pylori infection
Mucosa-associated lymphoid tissue (MALT) /
MALT lymphomas is associated with Chronic gastritis due to H.Pylori. t(11:18).
*White things on the oesophagus seen in OGD of an alcoholic man with recurrent bleeding varices. What are they?
Oesophageal Candidiasis
*Ca associated w coeliac
enteropathy-associated T-cell lymphoma (EATL)
*What is the most common histologic type of carcinoma involving the oral cavity?
SCC
*Oesophageal ca steps
Reactive -> metaplasia -> low grade dysplasia -> high grade dysplasia -> adenocarcinoma
*Coeliac ix
Duodenal biopsy
