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GI > Nelson Pathology-Oral and Esophageal Pathology > Flashcards

Nelson Pathology-Oral and Esophageal Pathology Flashcards

1
Q

Apthous Ulcers (Canker sores)

A
  • Shallow, superficial mucosal ulcerations
  • Painful, will recur
  • Single ulceration w/ an erythematous halo surrounding a yellowish fibrinopurulent membrane
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2
Q

Irritation Fibroma

A

Secondary to chronic irritation, like wearing dentures

  • Reactive proliferation of squamous mucosa and underlying supepithelial fibrous tissue
  • Firm nodule covered by granules
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3
Q

Pyogenic Granuloma

A

Polypoid red lesion composed of lobular reactive proliferation of capillaries
-Gingiva of children, young adults and pregnant women

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4
Q

Glossitis

A
  • Inflammation of tongue
  • Beefy-red appearance of the tongue that you see in deficiency states
  • Associated w/ Plummer-Vinson Syndrome
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5
Q

Plummer-Vinson Syndrome

A

Combo of IDA, glossitis, and esophageal dysphagia caused by esophageal webs

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6
Q

Geographic Tongue

A

Patches will migrate over time over the tongue

  • Migratory “map like” appearance of the tongue, due to focal loss of the papillae w/ formation of smooth red patches
  • Patients p/w mild burning sensation
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7
Q

Squamous Papilloma

A
  • Exophytic papillary proliferation of squamous mucosa w/ fibrovascular core (hyperplastic)
  • Some associated w/ HPV
  • Can undergo malignant transformation to in-situ and invasive squamous cell carcinoma
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8
Q

Hairy Leukoplakia (Appearance and clinical significance)

A

Appearance: White confluent patches of “fluffy” hyperkeratosis on the lateral sides of the tongue cannot be scraped off
Clinical: EBV infection causes hairy leukoplakia; may be first presenting sign of an HIV infection

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9
Q

Leukoplakia (Appearance and clinical significance)

A

Appearance: Hyperkeratosis (white plaque) that cannot be scraped off
Clinical: can demonstrate precancerous squamous dysplasia; more often in smokers

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10
Q

Erythroplakia (Appearance and Clinical)

A

Appearance: Red, velvety patch in the oral cavity that may be flat or eroded
Clinical: Higher chance than leukoplakia to be precancerous; more often in smokers

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11
Q

Actinic Cheilitis (Appearance and Clinical)

A

Appearance: Leukoplakic lesion of the lower lip w/ loss of the distinct demarcation b/w the lower lip vermillion border and the skin of the lip
Clinical: Preneoplastic lesion that can lead to squamous carcinoma

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12
Q

What are the similar risk factors for the development of oral cavity, oropharyngeal, hypopharyngeal and laryngeal squamous cell carcinoma?

A
  • Smoking and Drinking

- HPV

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13
Q

Risk factor for Nasopharyngeal SCC?

A

Common in Africa and South China

-EBV association

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14
Q

Why are inverted sinonasal papillomas more likely to recur than other sinonasal papillomas?

A
  • Thickened epithelial nests arising from the surface and growing down into the stroma
  • Greater likelihood that would leave some behind, leading to a greater chance of recurrence
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15
Q

Where is the most common site of metastases for oral cavity and pharyngeal SCC

A

Local: cervical neck lymph nodes
Distant: mediastinal lymph nodes, lungs, liver and bone

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16
Q

Xerostomia (Define and causes)

A

Dry mouth due to decrease in production of saliva

Causes: Sjogren’s, previous radiation, med side effects

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17
Q

Sialadentis (Define and causes)

A

Inflammation of the salivary glands

Causes: Trauma, mumps, Sjogren’s

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18
Q

LESA (Define and causes)

A
  • Lymphoepithelial sialadentitis
  • Autoimmune disease involving the salivary glands
  • Causes: Sjogren’s and HIV
19
Q

Cause and appearance of a mucocele

A

Cause: blockage or traumatic injury to a minor salivary gland w/ leakage of mucous contents into the surrounding CT stroma

20
Q

Pleomorphic Adenoma (Micro and Clinical)

A
  • Most common salivary gland tumor that is most commonly found in the parotid gland (mixed tumor)
  • Clinical: painless, discrete masses; firm, freely moveable
  • Well circumscribed but have small extensions or protrusions which make total resection difficult
  • High chance of recurrence
21
Q

Warthin Tumor

A
  • 2nd most common salivary gland tumor, almost always in the parotid
  • Benign, well encapsulated w/ a distinct micro appearance
  • ->Papillary, cystic lesion w/ a dual layer of bland, neoplastic, eosinophilic (oncocytic) epithelium
22
Q

Mucoepidermoid Carcinoma

A
  • Most common malignant salivary gland tumor in adults and children
  • Variable mix of mucous and squamous components; nests of each type
  • Clinical: Low grade tumors good prognosis; high grade tumors are very aggressive
23
Q

Adenoid Cystic Carcinoma

A
  • Slow growing but predisposed for NEURAL INVASION
  • Occur in minor salivary glands
  • Most common malignant tumor of minor salivary glands
  • Cribiform appearance enclosing secretions
24
Q

Most common benign salivary gland tumors?

A

Pleomorphic Adenoma

Warthin Tumor

25
Q

Most common malignant salivary gland tumor?

A 
Mucoepidermoid carcinoma (parotid)
Adenoid Cystic Carcinoma (minor)
26
Q

What salivary gland is most involved in salivary gland neoplasms?

A

Parotid gland

27
Q

Esophageal stenosis

A

Can be congenital; more commonly due to GERD

28
Q

Tracheoesophageal fistula

A

Type C most common patter; Esophageal atresia w/ distal TE fistula

29
Q

Esophageal Webs

A
  • Protrusions of mucosa that can cause obstruction
  • Seen in upper esophagus
  • Associated w/ Plummer-Vinson Syndrome
30
Q

Schatzki Rings

A
  • Esophageal rings
  • Thicker and circumferential forms of webs
  • may contain muscularis propia
  • Located in lower esophagus
31
Q

Zenker’s Diverticulum

A
  • Located above the UES as an outpouching of mucosa and the submucosa through a weakened posterior cricopharyngeus muscle
  • ONLY involves mucosa and submucosa
  • Can accumulate food and produce a mass
  • Can cause odonyphagia, halitosis, regurgitation and diverticulitis
32
Q

Mallory-Weiss Syndrome

A
  • Longitudinal mucosal lacerations in the distal esophagus and proximal stomach
  • Severe retching or vomiting after drinking a bunch of alcohol
33
Q

What is the complication of Mallory-Weiss Syndrome?

A

Boerhaave Syndrome: Transmural rupture of the distal esophagus w/ pneumomediastinum

34
Q

Hiatal hernia

A

Results from separation of the diaphragmatic crura and protrusion of the stomach into the thorax through the defect

  • Can be acquired later in life >50 yrs
  • Symptoms: inflammation (GERD), ulceration, stricture and hematemesis
35
Q

Most common type of a hiatal hernia?

A

Sliding Type

-Gastric cardia slides int the defect

36
Q

Three most common types of infectious esophagitis that can occur in immunocompromised

A
  1. Candida
  2. Herpes simplex
  3. CMV
37
Q

Pathogenesis of eosinophilic esophagitis

A
  • some type of allergic reaction to food allergens
  • mild eosinophilia seen in 40-50% of patients
  • Mucosa shows burrows, concentric rings and is studded w/ whitish-gray nodular plaques and exudates
38
Q

Microscopic appearance of eosinophilic esophagitis

A

Increased eosinophilic inflammation w/ basal epithelial hyperplasia w/o acute inflammation going on

39
Q

Clinical presentation of eosinophilic esophagitis

A

Food impaction, persistent dysphagia, GERD, symptoms that fail to respond to therapy

40
Q

Risk factors for esophageal adenocarcinoma

A

H/o Barrett’s and longstanding GERD

41
Q

Risk factors for esophageal squamous cell carcinoma

A

Alcohol and tobacco use, plummer-vinson syndrome, frequent hot beverage consumption

42
Q

Most common cause of esophageal squamous papillomas

43
Q

Most common benign mesenchymal tumor of the esophagus

GI (4 decks)

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