Oral and Oesophageal Pathology Flashcards
Reflux oesophagitis
Inflammation of the oesophagus due to refluxed low pH gastric content
What can cause reflux oesophagitis?
Defective sphincter mechanism +/- hiatus hernia, abnormal oesophageal motility, increased intra-abdominal pressure
Microscoping imaging in reflux oesophagitis
Basal zone epithelial expansion, intraepithelial neutrophils, lymphocytes and eosinophils
Complications of reflux oesophagitis
Ulceration, bleeding, stricture, Barrett’s oesophagus
Barrett’s oesophagus
Metaplasia - replacement of stratified squamous epithelium by columnar epithelium
Cause of Barrett’s oesophagus
Persistent reflux of acid or bile
Macroscopic imaging of Barrett’s oesophagus
Red velvety mucosa in lower oesophagus
Microscopic imaging of Barrett’s oesophagus
Columnar lined mucosa with intestinal metaplasia
Risks of Barrett’s oesophagus
Increased risk of developing dysplasia and carcinoma of the oesophagus
What type of WBC is associated with allergic oesophagitis?
Eosinophils
Risk factors for allergic oesphagitis
Personal/family history of allergy, asthma, young, male > female
Macroscopic view of oesophagus in allergic oesophagitis
Corrugated or ‘spotty’ oesophagus
Treatment for allergic oesophagitis
May include steroids/cromoglycate/montelukast
Which virus is related to squamous papilloma (benign oesophageal tumour?)
HPV
Very rare benign oesophageal tumours
- Leiomyomas
- Lipomas
- Fibrovascular polyps
- Granular cell tumours
Malignant oesophageal tumours
Squamous cell carcinoma, adenocarcinoma
Squamous cell carcinoma:
- Which gender is most affected?
- High risk areas
- Aetiology
- Males
- North Western France, Northern Italy, South Africa, Brazil, central China
- Vitamin A deficiency, zinc deficiency, tannic acid, smoking, alcohol, HPV, oesophagitis, genetic
Aetiology for adenocarcinoma
Males, caucasians, obesity
In which part of the oesophagus is adenocarcinoma most commonly found?
Lower 1/3rd
Pathogenesis of adenocarcinoma
Chronic reflux oesophagitis → Barrett’s oesophagus → low grade dysplasia → high grade dysplasia → adenocarcinoma
Mechanisms of metastases of carcinoma of the oesophagus
Direct invasion, lymphatic permeation, vascular invasion
General symptoms of malignancy due to effects of metastases
Anaemia, weight loss, loss of energy
High sites for oral squamous cell carcinoma
Floor of mouth, lateral border of and ventral tongue, soft palate, retromolar pad, tonsillar pillars
Aetiology of oral squamous cell carcinoma
Tobacco, alcohol, betel quid, nutritional deficiencies, post transplant, history of primary oral SCC
Histopathological features relating to prognosis of SCC
Tumour diameter, depth of invasion, pattern of invasion, lymphovascular invasion, neural invasion, involvement of surgical margins, metastatic disease
Treatment for SCC
Surgery +/- adjuvant therapy
