Oral and esophageal pathology Flashcards
Aphthous ulcer. Single ulceration with an erythematous halo surrounding a yellowish fibrinopurulent membrane (arrow).
, fibroma.
pyogenic granuloma
geographic tongue
Fordyce granules, characterized by heterotopic sebaceous glands (arrows).
Oral hairy leukoplakia characterized by the presence of demarcated white plaques to raised, white lesions with vertical corrugations on the lateral aspect of the tongue in a patient with HIV infection
. Microscopic image showing irregular epithelial hyperplasia with filiform or hair-like keratin projections, associated parakeratosis, and acanthosis
Squamous papillomas of the tonsil and uvula (above, left and right, arrows)
Squamous papillomas
leukoplakia
leukoplakia
The histologic features associated with a clinical leukoplakic lesion include hyperkeratosis with or without parakeratosis, often with irregular epithelial hyperplasia with or without dysplasia; in this example there is parakeratosis and absent dysplasia
Diffuse erythroplakia of the palate and uvula
erythroplakic lesion is associated with histologic evidence of dysplasia and/or carcinoma that may include severe dysplasia
carcinoma in situ (vertical arrow), and microinvasive carcinoma (horizontal arrow). from erythroplakia
Actinic cheilitis: Leukoplakic lesion of the lower lip with loss of the distinct demarcation between the lower lip vermilion border and the skin of the lip
actinic chellitis. histologic findings include disordered maturation of the epithelium with cytologic atypia, increased mitotic activity, orthokeratosis, and connective tissue solar changes
Squamous cell carcinoma of the lower lip (above left), lateral tongue (above right)
Squamous cell carcinoma of tonsil
Keratinizing invasive squamous cell carcinoma.
non-keratinizing (right) invasive squamous cell carcinoma.
Schneiderian papilloma, exophytic (septal) type.
the tumor has a papillary growth protruding from the surface respiratory epithelium composed of a thickened non-keratinized squamous (epidermoid) epithelium;
Schneiderian papilloma
magnification the epithelium shows cytomorphologic uniformity, retention of cellular polarity, absence of cytologic atypia, and the presence of scattered mucin microcysts and intraepithelial inflammatory cells.
Schneiderian papilloma, inverted type. Endophytic or ‘inverted’ growth pattern consisting of thickened epithelial nests arising from the surface and growing down into the stroma; the surface epithelium has undergone squamous metaplasia and the stroma is composed of a myxomatous to fibrous tissue with admixed chronic inflammatory cells.
, nasopharyngeal carcinoma, undifferentiated type. The syncytium-like nests of epithelium (arrow) are surrounded by lymphocytes
nasopharyngeal carcinoma
in-situ hybridization for EBV (EBER) is positive in the neoplastic cells.
laryngeal carcinoma. Note the large, ulcerated, fungating lesion involving the vocal cord and pyriform sinus.
obstructive sialadenitis
obstructive sialadenitis
parenchymal changes include marked inflammation and acinar atrophy; ducts are dilated and filled with mucopurulent material
Lymphoepithelial sialadenitis (LESA)
LESA presenting as a markedly enlarged left parotid gland along the mandible and lateral neck region.
Lymphoepithelial sialadenitis (LESA)
parotid gland parenchyma is replaced by a mature lymphocytic infiltrate in association with multiple germinal centers (arrows), as well as acinar atrophy and formation of lymphoepithelial lesions; this process is well demarcated from the adjacent salivary gland parenchyma, seen along the left side of this illustration
Lymphoepithelial sialadenitis (LESA)
characteristic appearance of a lymphoepithelial lesion represented by lymphocytic infiltration of proliferating ductal epithelium and obliteration of ductal lumina surrounded by a severe mixed chronic inflammatory cell infiltrate.
Mucocele: Fluctuant fluid-filled lesion on the lower lip subsequent to trauma
Mucocele
On the right, cystlike cavity filled with mucinous material (star) and lined by organizing granulation tissue, arrow).
Pleomorphic adenomas
submucosal painless palatal swelling
pleomorphic adenoma
Pleomorphic adenoma, fine needle aspiration
Warthin Tumor
Warthin Tumor
Mucoepidermoid carcinoma growing in nests composed of squamous cells as well as clear vacuolated cells containing mucin
Mucoepidermoid carcinoma
Mucicarmine stains the mucin reddish pink
Adenoid cystic carcinoma
The tumor cells have created a cribriform pattern enclosing secretions.
Adenoid cystic carcinoma
perineural invasion by tumor cells.
Zenker’s diverticulum
Hiatal hernia (type 1)
Viral esophagitis
multiple herpetic ulcers in the distal esophagus
Viral esophagitis
Multinucleate squamous cells containing Herpesvirus nuclear inclusions
Viral esophagitis
Cytomegalovirus-infected endothelial cells with nuclear and cytoplasmic inclusions
primary eosinophilic esophagitis
marked reactive squamous hyperplasia, numerous intraepithelial eosinophils (measuring >20 per high-power field), and accumulation of eosinophils in the superficial portions of the epithelium.
primary eosinophilic esophagitis
The esophageal mucosa shows burrows, concentric rings, and is studded with whitish-gray nodular plaques and exudates.
B, Barrett’s esophagus. Note the small islands of paler squamous mucosa within the Barrett’s mucosa
Barrett’s esophagus
transition between esophageal squamous mucosa (left) and Barrett metaplasia, with abundant metaplastic goblet cells
barret’s esophagus
Esophageal adenocarcinoma
Esophageal squamous cell carcinoma
squamous cell carcinoma (squamous nodules)
adenocarcinoma (forms glands)
Squamous papilloma
