Pathology of the mouth/esophagus

Question 1

What are the 3 Ms of a pathological HSV specimen/

Answer 1

1. Multinucleation
2. Margination of the nucleus
3. Molding of the nucleus

Question 2

What cells does HSV infect?

Answer 2

epithelial cells

Question 3

What are the features of cytomegalovirus?

Answer 3

Owl-eye appearance

Question 4

What types of cells does CMV infect?

Answer 4

endothelial and mesenchymal cells

Question 5

What does mucormycosis look like?

Answer 5

ONLY broad bulbous hyphal forms that are at 90 degree angles

Question 6

Pyogenic granuloma

Answer 6

Benign lobular capillary hemangioma

Question 7

Aphthous ulcer

Answer 7

self-resolution. Canker sore

Question 8

Leukoplakia

Answer 8

A white, hard, firm plaque. We worry that this will turn malignant.

Question 9

Hairy leukoplakia: benign or malignant? What is it associated with?

Answer 9

Benign. Seen in HIV pts assoc’d with EBV infection.

Question 10

What will you see on a hairy leukoplakia specimen?

Answer 10

hyperkeratosis, balloon cells, and acanthosis

Question 11

Erythroplakia

Answer 11

Pre-malignant

Question 12

What is squamous cell carcinoma assoc’d with?

Answer 12

smoking, alcohol, and HPV

Question 13

In which salivary glands are neoplasms most likely to be malignant?

Answer 13

sublingual

Question 14

What are two types of benign salivary gland tumors?

Answer 14

pleomorphic adenoma

warthin tumor

Question 15

What are three types of malignant salivary gland tumors?

Answer 15

mucoepidermoid carcinoma
Acinic cell carcinoma
Adenoid cystic carcinoma

Question 16

What types of cells do you see in a pleomorphic adenoma? Where are they most commonly found?

Answer 16

epitheial and myoepithelial. Found in the parotid gland

Question 17

What are you worried about with a pleomorphic adenoma of the salivary gland?

Answer 17

Malignant transformation has a poor prognosis

Question 18

Where would you find a warthin tumor?

Answer 18

parotid

Question 19

What are the two components of a warthin tumor?

Answer 19

epithelial and lymphoid

Question 20

What is the most common malignant tumor of the salivary gland?

Answer 20

Mucoepidermoid carcinoma

Question 21

What are the two types of cells in a mucoepidermoid malignant tumor?

Answer 21

mucus secreting and squamous

Question 22

What is a typical finding in a adenoid cystic carcinoma?

Answer 22

Perineural invasions

Question 23

Which of these salivary neoplasms has the best survival?

Answer 23

Mucoepidermoid

Question 24

In what conditions would you see an esophageal web?

Answer 24

Plummer vinson syndrome. Usually in women over 40

Question 25

What are the components of plummer vinson syndrome?

Answer 25

1. Web
2. Anemia
3. Gossitis
4. Cheilosis
5. Upper esophagus carcinoma

Question 26

What is a mallory-Weiss tear? How would it present?

Answer 26

Laceration at the GEJ. Will see forceful vomiting

Question 27

What is Boerhaave syndrome?

Answer 27

Esophageal rupture. Catastrophic

Question 28

In which patients would you see esophageal varices?

Answer 28

cirrhotic pts (90%!)

Question 29

What are the two types of esophageal carcinoma?

Answer 29

Squamous cell carcinoma and adenocarcinoma

Question 30

What kind of carcinoma does Barrett’s esophagus give rise to?

Answer 30

adenocarcinoma

Question 31

What are the criteria for Barrett’s esophagus?

Answer 31

1. Endoscopic evidence of columnar epithelium
2. Intestinal metaplasia (goblet cells)
   - ->The presence of goblet cells defines barrett esophagus

Question 32

How do you treat a platient with BE?

Answer 32

Routine surveillance and biopsy.

Question 33

What is the standard of care Tx for esophageal adenocarcinoma?

Answer 33

Esophagectomy. High morbidity and mortality