Pathology of oesophageal disease Flashcards
what is a common cause of oesophageal reflux ?
hiatus hernia
what initially happens to the epithelium in reflux ?
squamous epithelium thickens
ulceration can occur if severe
what are the complications of oesophageal reflux ?
healing by fibrosis - stricture, impaired motility, obstruction
Barrett’s oesophagus - metaplasia, pre-malignant
what are the two types of oesophageal cancers ?
adenocarcinoma - Barrett’s oesophagus
squamous carcinoma
what are risk factors for a squamous carcinoma ?
smoking
alcohol
dietary carcinogens
what are risk factors for an adenocarcinoma ?
Barrett’s oesophagus
obesity
what are the local effects of a cancer in the oesophagus ?
obstruction
ulceration
perforation
what are the different modalities of spread for an oesophageal cancer ?
direct
lymphatic - regional nodes
blood - liver
what are the three causes of gastritis ?
autoimmune - autoantibodies to parietal cells, atrophy of acid secreting epithelium
bacterial - commonly H.Pylori, increased acid, chronic inflammatory response
chemical - drugs (NSAIDs), alcohol, bile reflux
what causes a peptic ulcer ?
an imbalance between acid secretion and mucosal barrier
associated with H.Pylori
what are complications of a peptic ulcer ?
bleeding - acute or chronic
perforation - peritonitis
healing by fibrosis - obstruction
what is the most common histological type of stomach cancer ?
adenocarcinoma
what are the four modalities of spread for stomach cancer ?
direct
lymphatic
blood - liver
transcoelemic - peritoneal cavity
