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Gastrointestinal > Pathology of Mouth and Oesophagus > Flashcards

Pathology of Mouth and Oesophagus Flashcards

1
Q

inflammatory disorders or oesophagus

A

acute oesophagitis - rare

chronic oesophagitis - common

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2
Q

describe causes of acute oesophagitis

A

corrosive - chemical ingestion

infection -immunocompromised patients (e.g. candidates, herpes, CMV)

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3
Q

describe chronic oesophagitis

A 
reflux disease (reflux oesophagitis)
Crohn's disease - rare
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4
Q

what is reflux oesophagitis

A

inflammation of oesophagus due to refluxed low pH gastric content

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5
Q

causes of reflux oesophagitis

A

defective sphincter mechanisms +/- hiatus hernia
abnormal oesophageal motility
increase intra-abdominal pressure (pregnancy)

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6
Q

microscopic changes in reflux oesophagitis

A

basal zone epithelial expansion
lengthening of papillae
intraepithelial neutrophils, lymphocytes and eosinophils

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7
Q

complications of reflux oesophagitis

A

ulceration (bleeding)
stricture
Barrett’s oesophagus

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8
Q

what is Barrett’s oesophagus

A

metaplasia - replacement of stratified squamous epithelium by columnar epithelium

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9
Q

causes of Barrett’s oesophagus

A

persistent reflux of acid or bile - protective response, faster regeneration
expansion of columnar epithelium from gastric glands or from submucosal glands
differentiation from oesophageal stem cells

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10
Q

macroscopic changes in Barrett’s oesophagus

A

red velvety mucosa in lower oesophagus

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11
Q

microscopic changes in Barrett’s oesophagus

A

columnar lined mucosa with intestinal metaplasia

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12
Q

complications of Barrett’s oesophagus

A 
unstable mucosa (continuing damage) - requiring surveillance 
increased risk of developing dysplasia and carcinoma of oesophagus
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13
Q

what is allergic oesophagitis

A

eosinophilic oesophagitis

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14
Q

who is most likely to get allergic oesophagitis

A

asthmatics
younger patients
males > females
history of allergies

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15
Q

presentation of allergic oesophagitis

A

corrugated (feline) or spotted oesophagus
pH probe negative for reflux
increased eosinophils in blood

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16
Q

treatment for allergic oesophagitis

A

steroids
chromoglycate
montelukast

17
Q

benign tumours of oesophagus

A

squamous papilloma

18
Q

describe squamous papilloma

A

rare
papillary
asymptomatic
HPV related

19
Q

very rare benign tumours of oesophagus

A

leiomyomas
lipomas
fibrovascular polyps
granular cell tumours

20
Q

malignant tumours of oesophagus

A

squamous cell carcinoma

adenocarcinoma

21
Q

who is more likely to get squamous cell carcinoma

A

males > females

22
Q

causes of squamous cell carcinoma

A 
vitamin A, Zinc deficiency 
tannic acid/strong tea
smoking
alcohol 
HPV
oesophagitis 
genetic
23
Q

who is more likely to get adenocarcinoma

A

common in caucasians
males > females
obesity

24
Q

pathophysiology of adenocarcinoma

A

commonest in lower 1/3 oesophagus

25
Q

mechanisms of metastases of carcinoma of the oesophagus

A

direct invasion
lymphatic permeation
vascular invasion

26
Q

symptoms of carcinoma of oesophagus

A 
dysphagia 
general symptoms of malignancy;
anaemia
weight loss
fatigue
27
Q

presentation of oral squamous cell carcinoma

A 
variable;
white
red
speckled
ulcer
lump
28
Q

where are oral squamous cell carcinomas located - high risk sites

A

floor of mouth
lateral border of and ventral tongue
soft palate
retromolar pad/tonsillar pillars

29
Q

where are oral squamous cell carcinomas located - rare sites

A

hard palate

dorsum of tongue

30
Q

cause of oral squamous cell carcinomas

A 
smoking
alcohol
betel quid
HPV
chronic infections
nutritional deficiencies 
genetics 
post transplant 
history of primary oral squamous cell carcinoma - increased risk of developing new second primary
31
Q

microscopic oral squamous cell carcinoma

A

malignant squamous epithelium - invasion and destruction of local tissues

32
Q

how are squamous cell carcinomas graded

A

by degree of differentiation

33
Q

TNM system

A

staging tumours;
T - diameter of tumour, structures invaded
N - lymph node status
M - metastasis

34
Q

treatment of oral squamous cell carcinomas

A

surgery
+/- adjuvant therapy
(late detection of tumour)

Gastrointestinal (71 decks)

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