Pathology of the Esophagus Flashcards
what are causes of esophagitis
1)Chemical injury
Reflux of gastric contents
Acids, alkalis (e.g. lye), alcohol, tobacco
Medications (e.g. “pill” esophagitis and
chemotherapeutics)
2)Infection
Fungal (e.g. Candida) Viral (e.g. Herpes simplex virus)
3)Immune related diseases
Eosinophilic esophagitis
Dermatologic diseases (e.g. lichen planus)
4) Radiation
5) Trauma
what is reflux esophagitis …
…it is injury and inflammation that results from reflux of gastric contents into the esophagus
…results in gastroesophageal reflux disease:
In herpetic esophagitis what is seen on endoscopy and histology
endoscopy: punched out ulcers
Histology: viral inclusions
In Candida esophagitis, what is observed in endoscopy and histology
endoscopy: white plaques
Histology: fungus
what is seen on endoscopy and histology for Eosinophilic Esophagitis
Endoscopcy: ringed esophagus with linear furrows
Histology: lots of Eosinophils
what is Zenkers diverticula
occurs in Uppermost portion of the esophagus
Sx’s include Regurgitation, halitosis (bad breath), and aspiration (clinical: gurgling)
Associated with reduced UES compliance
what is the definition of diverticulum
an abnormal sac or pouch formed at a weak point in the wall of the alimentary tract.
Descibe Mid Esophagus diverticula clinical presentaion
Usually asymptomatic, associated with mediastinal inflammation (ie TB)
describe Epiphrenic diverticula
Symptomatic, secondary to coexistence with hiatal hernia
What are Esophageal webs and rings
Acquired,
Clinically account for 5-15% of dysphagia or choking sensation,
More common in females > 40 years of age
describe the Sx’s of esophageal webs and rings
Mostly asymptomatic,
Dysphagia and odynophagia (Pain on swallowing food and fluids) are common symptoms.
what is ESOPHAGEAL ATRESIA AND TRACHEOESOPHAGEAL FISTULA
Congenital anomalies resulting from failure of the foregut to divide into trachea and esophagus during the fourth week of embryonic development
what is Congenital esophageal stenosis
Anomaly demonstrates a significant narrowing of the mid-esophagus by way of:
Esophageal web/ rings
Muscular hypertrophy
Inflammation
what is Nutcracker esophagus
Motility disorder caused by extensive hypertrophy of the inner muscle layer
what causes Corkscrew esophagus
Diffuse esophageal spasms
what are Mallory-Weiss tears
tears in esophagus from severe retching or vomiting, often associated with alcohol intoxication
what is Boerhaave syndrome
rupture of the esophagus from severe retching or vomiting, often associated with alcohol intoxication
______ % of low grade dyplsasia in barretts esophagus will become adenocarcinoma
~ 2- 12
______% of high grade dysplasia in barretts esophagus will become adenocarcinoma
~ 16- 60%
adenocarcinoma is asscociated with ______
GERD,
tobacco use,
radiation exposure
adenocarcinoma occurs more commonly in _____
men (7 M : 1 F)
Sqaumous cell carcinoma is more common ________, and is associated with _______
world-wide (Asia and Africa) and in men (4 M : 1 F) and in African Americans (8 AA : 1 US Caucasian)
alcohol, tobacco, and dietary factors
overall 5-year survival of squamous cell carcinoma of the esophagus is _______
~ 5-10%
overall 5-year survival of adenocarcinoma of the esophagus is _______
~25%
what is the Tx of Eosinophilic Esophagitis
Elimination of food allergens and the swallowing of topical corticosteroids are the treatments of choice.
