Oral and oesophageal pathology Flashcards
What is the z line?
Present at gastro-oesophageal junction where epithelium changes from stratified squamous to columnar in stomach
What can cause acute oesophagitis?
Corrosive following chemical ingestion
Infective in immunocompromised patients
What can cause chronic oesophagitis?
Reflux disease
Crohn’s disease (rare)
What is reflux oesophagitis?
Inflammatino of oesophagus due to refleuxed low pH gastric content that may be due to defective sphincter, abnormal oesophageal motility or increased intra-abdominal pressure
What can be seen microscopically in reflux oesophagitis?
Basal zone epithelial expansion
Intraepithelial neutrophils, lymphocytes and eosinophils
What are the complications of reflux?
Ulceration (bleeding)
Stricture
Barrett’s oesophagus (replacement of stratified squamous epithelium by columnar epithelium)
What is allergic oesophagitis?
Eosinophilic oesophagitis Personal/family history of allergy Asthma Young Affects more males that females Increased eosinophils in blood
How is allergic oesophaitis treated?
Steroids
Chromogoycate
Montelukast
What are examples of benign oesophageal tumours?
Squamous papilloma
Papillary
What are examples of malignant oesophageal tumours?
Squamous cell carcinoma
Adenocarcinoma
What can cause squamous cell carcinoma?
Vit A and zinc deficiency Tannic acid Smoking, alcohol HPV Oesophagitis Genetic
What can cause adenocarcionma of the oesophagus?
Commoner in caucasions
Commoner in obese males
Commonest in lower 1/3rd of oesophagus
What is the pathogenesis of adenocarcinoma of the oesophagus?
Genetic factors, reflux disease Chronic reflux oesophagitis Barretts oesophagus Low grade dysplasia High grade dysplasia Adenocarcinoma
What are the mechanisms of metastasaes of carcinoma of the oesophagus?
Direct invasion
Lymphatic permeation
Vascular invasion
What can carcinoma of the oesophagus present with?
Dysphagia
Anaemia
Weight loss, loss of energy
