Oral Pathology

Question 1

What are the inflammatory disorders?

Answer 1

1) Acute oesophagitis - corrosive chemical ingestion.
Infective in immunocompromised individuals
Eg. Candidiasis, herpes, HIV

2) Chronic Oesophagitis / Reflux Oesophagitos
Relase of stuff from stomach to oesophagus
Low ph gastric content

Question 2

What is reflux oesophagus?

Answer 2

Inflammation of oesophagus due to refluxed low ph gastric content

Maybe due to defective sphincter mechanism, abnormal oesophageal motility, increased andominal pressure (pregnancy)

Question 3

What happens histologically in reflux oesophagus?

Answer 3

Basal cell hyperplasia. Increased proliferation to compensate for cell desquamatisation in basal zone (100× normal rate)
Accumulation of neutrophils and eosinophils
Lengthening of papillae
Hence higher chances of mistakes

Question 4

What happens in oesophageal ulcer?

Answer 4

Discontinuation of the cell surface, bleeding and stricture (blockage). Chronically leads to barrets oesophagus - statified squamous to columnar cells with glandular epithelium (produces mucus) and it is more resistant to acid.

Question 5

What is barrets oesophagus

Answer 5

barrets oesophagus - statified squamous to columnar cells with glandular epithelium (produces mucus) and it is more resistant to acid.
This layer of cells is unstable and at a high risk of dysplasia and carcinoma

Question 6

What is allergic oesophagitis?

Answer 6

Corrigated/ ridged oesophagus, like a cats trachea
Large numbers of intraepithelial eosinophils
Very resistant to treatment and only works to anti- allergic medications

Question 7

What are the medications for allergic oesophagitis?

Answer 7

Anti- allergic medication - steroids/ montelukast, chromoglycate

Question 8

What are benign oesophageal tumours amd their frequency?

Answer 8

Rare, squamous papilloma, asymptomatic, HPV related

……

Question 9

What are the various malignant oesophageal tumours?

Answer 9

Squamous cell carcinoma

Adenocarcinoma

Question 10

Aetiology for Sq. Cell carcinoma

Answer 10

Vit A, Zn. Deficiency
Tannic acid/ strong tea
Smoking
Alcohol
Tobacco
HPV (infectious - rare)
Oesophagitis

Question 11

What does squamous cell carcinoma do?

Answer 11

It causes severe obstruction by reducing the lumen, and dysphagia. Even grows into the adventitia.

Question 12

What do squamous cells produce when they are malignant?

Answer 12

Keratin

Question 13

*Pathogenesis of Adenocarcinoma of oesophagus

Answer 13

IMP

Question 14

What is the step before invading cancer in adenocarcinoma?

Answer 14

High grade dysplasia

Question 15

Does adenocarcinoma produce dysphagia?

Answer 15

Yes, obstruction, dysphagia and spread to adventitious tissue

Question 16

*what are the Mechanisms of metastases im oesophageal cancer/ most cancers?

Answer 16

1) direct invasion
2) lyphatic permeation
3) vascular invasion

Question 17

What are the clinical presentation of oesophageal carcinoma

Answer 17

1) Dysphagia

2) General symptoms -

Question 18

What is the most common oral cancer?

Answer 18

Squamous cell carcinoma

Question 19

High risk sites in mouth for oc

Answer 19

Floor of mouth, tonsils, palate…

Question 20

Aetiology of oc

Answer 20

COMMON

Smoking
Alcohol
Tobacco

RARER

HPV

Question 21

Histopathological chamges in oc

Answer 21

Whirls, invasive finger like growth….

Question 22

How is the prognosis of SCC?

Answer 22

1) tumour diameter
2) depth of invasion
3) pattern of invasion - cohesive vs non-cohesive
4) lymphovascular invasion
5) neural invasion by tumour
6) involvement of sugrical margins
7) metastatic disease
8)