Oral and Oesophageal Pathology Flashcards
What are the main two inflammatory disorders of the oesophagus?
Acute Oesophagitis (rare) and Chronic oesophagitis (common)
What can cause acute oesophagitis?
Corrosive following chemical ingestion
Infective in immunocompromised patients e.g. candidiasis, herpes, CMV
What can cause chronic oesophagitis?
Reflux disease (reflux oesophagitis) Rare causes include Crohn's disease
What causes reflux in pregnant women
Increased abdominal pressure
Define reflux oesophagitis
Inflammation of the oesophagus due to refluxed low pH gastric contents
Microscopically, what can be seen in the oesophagus of reflux oesophagitis?
Basal zone epithelial expansion
Intraepithelial neutrophils, lymphocytes and oesinophils
List some complications of reflux
Ulceration (bleeding)
Stricture
Barrett’s oesophagus
What is Barrett’s oesophagus
Replacement of stratified squamous epithelium by columnar epithelium
Describe the epidemiology of allergic oesophagitis
Eosinphillic oesophagitis Personal or family history of allergy Asthma Young Males > Females
What is the treatment for allergic oesophagitis
Steroids / chromoglycate / montelukast
What are the two different types of oesophageal tumours
Benign and Malignant
What is the most common type of benign tumour
Squamous papilloma
What are the 2 main types of malignant tumours and which one is most common?
Squamous cell carinoma
Adenocarcinoma (more common)
Describe the epidemiology of squamous cell carincoma
Commoner in males
Declining
Probably something to do with diet and culture
Describe the aetiology of squamous cell carcinoma
Vit. A, zinc deficiency Tannic acid/ strong tea Smoking, alcohol HPV Oesophagitis Genetic
Describe the aetiology of adenocarcinoma of the oesophagus
Commoner in caucasians (white person with European origin)
Increasing in Europe and USA
Commoner in males and obesity
Commonest in the lower 1/3rd of the oesophagus
What is the pathway to Barrett’s oesophagus
Inflammation, metaplasia, dysplasia, adenocarcinoma
Name the 3 mechanisms of metastases
Direct invasion
Lymphatic permeation
Vascular invasion
How would patients present with oesophageal carcinoma
Dysphagia
Anaemia
Weight loss
Loss of energy
What are the symptoms of oral squamous cell carcinoma
White, red, speckled, ulcer, lump
Where are the high risk sites
Floor of the mouth Lateral border of tongue Ventral tongue Soft palate Retromolar pad / tonsillar pillars
What is the aetiology of oral cancer
Tobacco Alcohol Betel quid ?Chronic infections Nutritional deficiencies ? Genetics History of primary oral squamous cell carcinoma have increased risk for 2nd primary
What is the reason for no improved survival in the last few decades
Late detection
