Oral Esophageal Pathology

Question 1

What diseases are apthous ulcers associated with?

Answer 1

Celiac and IBS

Question 2

What is a pygoenic granuloma?

Answer 2

red lesion of the gingiva- reactive proliferation of capillaries.

Question 3

What are the 3 signs of Plummer Vincent syndrome?

Answer 3

glossitis, iron deficient anemia and esophageal dysphagia

Question 4

What is a fibroma?

Answer 4

proliferation -squamous mucosa and underlying subepithelial tissue - chronic irritation.

Question 5

In what disorder would you see beefy red tongue, papilarry atrophy and thinning of the mucosa?

Answer 5

Glossitis

Question 6

What is the cause of geographic tongue?

Answer 6

Loss of papillae due to neutrophilic inflammation.

Question 7

What are Fordyces granules?

Answer 7

Heterotropic collection of sebeacous glands in the oral cavity.

Question 8

This oral disease is a proliferation of oral squama in reaction to oral irritation or HPV and can transition to SCC

Answer 8

Squamous papilloma

Question 9

If you see hairy leukoplakia what do you think?

Answer 9

First gross. Then do the fluffy patches wipe off? If not probably EBV in an HIV pt.

Question 10

Clinical significance of leukoplakia?

Answer 10

Precancerous and 5-20% exhibits squamous dysplasia.

Question 11

What type of precancerous lesion has flat red velvety patches?

Answer 11

Erythroplakia

Question 12

What is actinic cheilitis?

Answer 12

a form of actinic keratoses on the lip, can be scaly. from sun exposure

Question 13

Key risk factors for mouth, laryngeal, pharyngeal SCC vs. nasopharygal SCC?

Answer 13

Mouth and others - smoking, HPV, alcohol

Nasopharyngeal - EBV

Question 14

Why is an inverted sinonasal papiloma more likely to reocurr than other papillomas?

Answer 14

Because of its inverted growth pattern.

Question 15

What is the most common site of metastasis for oral cavity and pharyngeal SCC?

Answer 15

Cervical lymph node.

Question 16

Define xerostomia

Answer 16

Decreased saliva production

medications, Sjogren’s and radiaton

Question 17

Define sialadenitsis

Answer 17

Inflammation of the salivary gland. Caused by trauma, infection, autoimmune, sialothialis.

Question 18

Define lymphoepithelialiocyoadenitis? (Mikulicz disease) common cause?

Answer 18

Polyclonal lymph inflammation and gland enlargement, most common cause is autoimmune, Sjogrens. rule out B-cell MALT lymphoma

Question 19

Describe cause and appearance of mucocele?

Answer 19

leakage of minor salivary glands into surrounding tissue caused by blockage or traumatic injury.
Fluid filled nodule.

Question 20

Describe pleomorphic adenoma

Answer 20

Most common parotid tumor.
epithelial (ductal and myo) and mesenchymal matrix of mixoid hyaline and choindroid.
all kinds of fingers.

Question 21

Describe appearance of a Warthin tumor

Answer 21

well encapsulated papillary cystic lesion with 2 layers of bland neoplastic eosinophilic epithelium with reactive lymphoid stroma. parotid gland only

Question 22

Describe the appearance and clinical features of mucoepidermoid carcinoma.

Answer 22

Mix of squamous and mucus secreting intermediate cells s. Most common salivary gland malignancy.
Usually parotid gland

Question 23

Describe appearence and clinical of adenoid cystic carcinoma.

Answer 23

common - minor salivary. Slow growing, invades neural tissue.
spread to lungs, bones, liver, brain long after resection. Survival rates half every 5 years.

Question 24

What are the most common benign and malignant salivary gland tumors?

Answer 24

benign- pleomorphic adenoma

malignant- mucoepidermoid carcinoma

Question 25

What is the difference between an esophageal mucosal web and a schatzi ring?

Answer 25

esophageal mucosal web- upper esophagus mucosal protrusions

schatzi ring- thicker, has muscular propria, circumferential in lower esophagus

Question 26

Drinking like a fool and retching all night causes lacerations where?

Answer 26

lacerations of distal esophagus and proximal stomache- Mallory Weiss syndrome, or Booerhaave

Question 27

What are the symptoms of Zenker’s diverticulum?

Answer 27

painful swallowing and regurgitation caused by food built up in pharyngeal pouch

Question 28

Congratulations, you have a hiatal hernia! How did this happen and what type do you likely have?

Answer 28

could have been congenital but likely acquired, most common type is sliding

Question 29

Your patient has AIDS and infectious esophagitis. What are the most likely microbes to have caused the infection?

Answer 29

Candida, Herpes, CMV

Question 30

Tell me everything you know about eosinophilic esophagitis, Go!

Answer 30

allergic rxn to food allergens
get food impaction, dysphagia, GERD that just won’t quit, kids- feeding disorders/vomiting
eosinophilic inflammation w/ basophilic hyperplasia

Question 31

Describe the dysplasia seen in Barrett’s esophagus

Answer 31

normal squamous mucosa turns to non-ciliated simple columnar, major SE = adenocarcinoma

Question 32

Name the most common benign mesenchymal tumor of the esophagus

Answer 32

leiomyoma

Question 33

this benign neopasm is assocated with HPV

Answer 33

squamous papilloma

Question 34

What are some causes of esophageal squamous cell carcinoma?

Answer 34

smoking, alcohol, achlasia, plummer vinson, hot beverages, HPV