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GI > Oral and Oesophageal pathology > Flashcards

Oral and Oesophageal pathology Flashcards

1
Q

What is acute oesophagitis?

A

Corrisve following chemical ingestion

Infection in immunocompromised patients (candidtis, herpes, CMV)

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2
Q

What is chronic oesophagitis?

A

Relfux disease - reflux oesophagitis

Rare causes include crohn’s disease

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3
Q

What is the definition of reflux oesophagitis?

A

Inflammation of oesophagus due to refluxed low pH gastric content

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4
Q

What can cause reflux oesophagitis?

A

May be due to defective sphinter mechanism +/- hiatus hernia
Abnormal oesophageal motility
Increased inta-abdominal pressure (regnancy)

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5
Q

What does reflux oesophagitis look like microscopically?

A

Basal zone epithelial expansion

Intraepithelial neutrophils, lymphocytes and esoinophils

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6
Q

What are complications of reflux?

A

Ulceration (bleeding)
Stricutre
Barrett’s oesophagus (replacement of stratified squamous epithelium by columnar epithelium)

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7
Q

Why does metaplasia occur in barrett’s oesphagus?

A

Presistent reflux of acid or bile
May be due to expansion of columnar epithelium drom gastric glands or from submucosal glands
May be due to differentiation from oesophageal stem cells
Protective response, faster regeneration

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8
Q

What is barrett’s oesphagus?

A

Unstable mucosa that is at high risk of developing dysplasia and carcinoma of the oesophagus
Requires surveilllance

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9
Q

What is allergic oesphagitis?

A

Eosinophilic oesophagitis, occurs in people with a family history of allergy or asthm

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10
Q

Who does allerigic oesophagitis tend to affect?

A

Young

Males more than females

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11
Q

How is allergic oesphagitis diagnosed?

A

pH probe for reflux
Increased eosinophils in the blood
Corrugated (feline) or spotty oesophagus

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12
Q

How can allergic oesophagitis be treated?

A

Steroids/chromoglycate/montelukast

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13
Q

What are examples of benign oesophageal tumours?

A 
Squamous papilloma
Rare, papillary, assymptomatic, HPV related
Leiomyomas
Lipomas
Fibrovascular polyps
Granular cell tumours
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14
Q

What are examples of malignant oesophageal tumours?

A

Squaomous cell carcinoma

Adenocarcinoma

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15
Q

Who does squamous cell carcinoma affect?

A

Commoner in males

High risk in NW France, N italy, Iran, S. Africa, brazil, central china

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16
Q

What causes squamous cell carcinoma?

A 
Vitamin A and Zinc deficiency 
Tannic acid/strong tea
Smoking, alcohol
HPV
Oesophagitis
Genetic
17
Q

Who is likely to get adenocarcionma of the oesophagus?

A

Commoner in caucasians
Incidence increasing in Europe and USA
Commoner in males/obesity
Commonest in lower 1/3rd of oesophagus

18
Q

What is the pathogenesis of adenocarcinoma of the oesophagus?

A 
Genetic factors, reflux disease, others 
Chronic reflux oesphagitis 
Barretts oesophagus
Low grade dysplasia
High grade dysplasia
Adenocarcinoma
19
Q

What are the mechanisms of metastases in carcionma of the oesophagus?

A

Direct invasion
Lymphatic permeation
Vascular invasion

20
Q

What does carcinoma of the oesophagus present with?

A

Dysphagia (due to tumour obstruction)

General symptoms of malignancy - anaemia, weight loss, loss of energy

21
Q

What is the presentation of oral squamous cell carcionma?

A

White, red, speckled, ulcer, lump

22
Q

Where are the high risk sites for oral squamous cell carcionma?

A

High risk sites include floor of mouth, laeral border of ventral tongue, soft palate, retomolar pad/tonsillar pillars

23
Q

What causes oral cancer?

A 
Tobacco
Alcohol
Betel quid
Viral 
Chronic infections
Nutritional deficiencies 
Post ransplant
24
Q

How is the prognosis calculated for a SCC?

A 
Tumour diametes
Depth of invasion 
Pattern of invasion 
Lymphovascular invasion 
Nueral invasion by tumour 
Involvement of surgical margins 
Metastatic disease 
Extracapsular spread of lymph node metastases
25
Q

How are oral cancers treated?

A

Surgery +/- adjuvant therapy

GI (42 decks)

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