pathology of esophagus and stomach

Question 1

the esophagus begins in the _____ and ends at the _____

Answer 1

begins in the lower end of thepharynx and ends at the gastroesophageal junction

Question 2

length of esophagus

Answer 2

25-27

Question 3

3 distinct anatomic portions of esophagus

Answer 3

cervical
thoracic
abdominal

Question 4

3 muscle layers of the esophagus

Answer 4

Inner circular
Middle oblique
Outer longitudinal

Question 5

consists of cells with abnormal nuclear morphology andabnormal architecture due to loss of polarity

Answer 5

SQUAMOUS CELL DYSPLASIA

Question 6

95% of esophageal carcinomas have

Answer 6

dysplasia

Question 7

most common type of malignancy of the esophagus

Answer 7

SCC

Question 8

why prognosis of SCC is poor

Answer 8

prognosis poor since tumor growth and spread to adjacent structures and lymph nodes are rapid

Question 9

small gray white plaque like thickenings to polypoid, exophytic and protruding obstructing lumen

Answer 9

SCC

Question 10

adenocarcinoma is commonly in the _____ segments of the esophagus

Answer 10

middle and lower segment (distal third)

Question 11

adenocarcinoma most arise from

Answer 11

Barrett’s esophagus and long standinggastroesophageal reflux disease (GERD)

Question 12

`Most arise from Barrett’s esophagus and long standinggastroesophageal reflux disease (GERD)

Answer 12

ADENOCARCINOMA

Question 13

what event in the pathogenesis of adenoCA that suggests that inflammation contribute to neoplastic progression

Answer 13

increased epithelial expression of TNF and NF kB dependent genes

Question 14

char of adenoCA

Answer 14

Papillary exophytic growth of adenocarcinoma

Histology of adenocarcinoma showing glands lined by malignant cells

Question 15

Poorly differentiated variant

Answer 15

Signet Cell Ring Carcinoma

Question 16

describe a Signet Cell Ring Carcinoma

Answer 16

it has an abundant cytoplasm and peripherally located nucleus

Question 17

why gastric carcinoma is often found in mountain regions

Answer 17

possibly due to soils and trace elements

Question 18

predisposing factors of gastric CA

Answer 18

gastric atrophy, intestinal metaplasia ad dysplasia

Question 19

2 general histologic types of gastric ca

Answer 19

intestinal

diffuse

Question 20

advanced gastric CA may extend into

Answer 20

muscular wall

Question 21

survival rate of gastric CA

Answer 21

15% 5 year survival rate

Question 22

GI stroma are classified on the basis of

Answer 22

depth of invasion
macroscopic growth
histologic subtype

Question 23

microscopic examination of GI stromal tumors shows

Answer 23

spindle cells with vacuolated cytoplasms

Question 24

Increased tone of the lower esophageal sphincter (LES)

as a result of impaired smooth muscle relaxation

Answer 24

achalasia

Question 25

triad of achalasia

Answer 25

Incomplete LES relaxation Increased LES tone Aperistalsis of the esophagus

Question 26

Tears near GE junction often associated with severe retching or vomiting secondary to acute alcoholic intoxication

Answer 26

Mallory Weiss Tears

Question 27

Complication of Chronic GERD

Answer 27

BARRETT’S ESOPHAGUS

Question 28

invasion of lamina propria

Answer 28

CIS (carcinoma in-situ)

Question 29

These are mesenchymal tumors derived from thepacemaker cells of Cajal.

Answer 29

Gastrointestinal stromal tumors (GISTs)

Question 30

Between the two histologic types of gastriccarcinoma, which one is predominantly associatedwith males and characterized by bulky tumors?

Answer 30

Intestinal Gastric Carcinoma

Question 31

5.“Keratin pearls” are the key feature of whatvariant of squamous cell carcinoma?

Answer 31

Well differentiated SCC

Question 32

this is the char of what type of gastric CA: Infiltrative ─ Poorly differentiated, dicohesive (gastric mucous cells, signet ring) ─ 48 y/o, M=F

Answer 32

DIffuse

Question 33

char of diffuse type of gastric CA

Answer 33

Infiltrative ─ Poorly differentiated, dicohesive (gastric mucous cells, signet ring) ─ 48 y/o, M=F