Pathology Esophagus Flashcards
Lymph drainage Esophagus
|Upper: Cervical
Middle: Mediastinal
Lower: Celiac/gastric
Plummer-vinson syndrome
- Upper esophageal web w/ Fe-deficient anemia + Mucosal leasions
- Complications can result in carcinoma
Schatzki ring
- Narrowing of esophagus near gastroesophageal junction
- Congenital or GERD
Achalasia Path
- INC LES tone + abcent esophageal peristalsis
- Inflammatory T Cell disorder causing loss of inhibitory neurons in myentertic plexus
Achalasia Morph
- “bird beak” appearance on radiographs
- INC inflammatory cells
Secondary Achalasia
Chagas Disease
Achalasia Tx
LES Botox, endoscopic myotomy, or endoscopic balloon dilation
Hiatal hernias + Tx
Sliding: Cap of gastric cardia protrudes upward: Tx medically
Paraesophageal: Gastric fundus protrudes alongside esophagus: Tx surgically
Esophageal Diverticula types
True: All layers w/ muscular layer False: No muscular layer Zenker's: False Above UES Traction: Middle esophagus Epiphrenic: Above LES
Mallory Weiss Syndrome
- Longitudinal mucosal laceration in the distal esophagus and proximal stomach typically occurring after repeated episodes of severe vomiting or forceful retching
- A/S: Alcoholism, painful hematemesis, mediastinitis (Boerhaave Sx)
Esophageal Varices
- Dilated distal esophageal veins
- Cirrhosis/Portal hypertension
- Hematemesis, melena, life-threateing GI bleeds
Reflux Morphology
Hyperemia; Superficial mucosal erosions/ulcers; vertical linear streaks
Replacement of esophageal squamous epithelium by columnar epithelium (metaplasia) that usually occurs in the lower third of the esophagus as a complication of chronic GERD.
Barrett Esophagus
Barret Esophagus Morphology
- Reddish “tongues” of mucosa (metaplastic) extending from the GE junction
- Columnar Epithelium + Goblet Cell formation OR other GI Cell metaplasia
Eos. Esophagitis Morph
- Concentric mucosal rings “Trachealization”
- INC superficial eosinophils w/ microabcesses
