*Oesophageal and Stomach Disorders (lectures 3 and 4) Flashcards
What mucosa lines the normal oesophagus?
Stratified squamous epithelium
What tends to cause acute oesophagitis?
Rare but usually caused by corrosion following chemical ingestion or infection in immunocompromised patients e.g. candidiasis, herpes
What tends to cause chronic oesophagitis?
Reflux disease - “reflux oesophagitis)
Rarely, caused by crohns
What is reflux oesophagitis?
Inflammation of oesophagus due to refluxed low pH gastric content
Microscopic appearance of reflux oesophagitis?
Basal zone epithelial expansion (hyperplasia)
Intraepithelial neutrophils, lymphocytes and eosinophils
What is Barrett’s oesophagus?
Replacement of stratified squamous epithelium by columnar epithelium with intestinal metaplasia
How does the metaplasia occur in Barrett’s oesophagus?
Due to expansion of columnar epithelium from gastric glands or from submucosal glands
Due to differentiation from oesophageal stem cells
What is allergic oesophagitis?
Other name
An inflammatory condition in which the walls of the oesophagus become filled with eosinophils
“eosinophillic” oesophagitis
What type of patients does allergic oesophagitis tend to occur in?
Those with a personal/ family history of allergy e.g. asthma
Young
Males more than females
pH probe of allergic oesophagitis?
Negative for reflux
Blood test in a patient with allergic oesophagitis?
Increased eosinophils
Appearance of an allergic oesophagitis?
Corrugated or “spotty” oesophagus
Treatment for allergic oesophagitis?
Steroids/ chromoglycate/ montelukast
What benign tumours are most commonly found in the oesophagus?
What are they associated with
Squamous papillloma
Rare
HPV
Other benign tumours of the oesophagus apart from squamous papilloma?
Leiomyomas Lipomas Fibrovascular polyps Granular cell tumours VERY rare
What is the commonest type of oesophageal cancer in males?
Squamous cell carcinoma
Causes of squamous cell carcinoma?
Vitamin A, zinc deficiency Tannic acid/ strong tea Smoking, alcohol Oesophagitis Genetic
What is commonest type of oesophageal cancer in caucasians?
Adenocarcinoma
Steps to developing adenocarcinoma of oesophagus?
genetics, reflux, etc. - chronic reflux oesophagitis - barretts oesophagus - low grade dysplasia - high grade dysplasia - adenocarcinoma
What type of cancers are the majority of oral cancers?
Squamous cell carcinoma
What parts of the mouth is it rare to develop cancer on?
Hard palate
Dorsum of tongue
Causes of squamous cell carcinoma of the oral cavity?
Tobacco Alcohol Betel quid Viral? (HPV) Chronic infections? Nutritional deficiencies ?genetics
Staging system for oral cancer?
TNM system
Treatment of oral cancer?
Surgery +/- adjuvant therapy