Pathology of the Upper GI Tract Flashcards
Where do head and neck cancers commonly spread to?
Lymph nodes in the neck
What are the risk factors for oral cancer?
Smoking
Alcohol
HPV infection
An ulcer which will not heal is a classic presentation of…?
Cancer
Acid and digestive enzymes in reflux disease will injure the squamous epithelium of the oesophagus. Describe the probable histological appearance of this
Increased numbers of inflammatory cells and the basal zone of the epithelium will be hyper plastic
What infections typically occur in the oesophagus?
Candida albicans
Herpes simplex virus
What will be the histological appearance of the oesophagus when infected with Candida albicans?
Active chronic inflammation with many neutrophils near the luminal surface
How can Candida albicans infection of the oesophagus be confirmed?
PAS stain to confirm spores and hyphae of Candida albicans
What tablets can typically cause inflammation of the oesophagus?
Iron
Bisphosphonate
Tetracycline
What conditions is Barret’s oesophagus associated with?
Benign strictures
Adenocarcinoma
What can mimic oesophageal dysplasia?
Inflammation or reactive changes
How many biopsies should be taken at endoscopy to find dysplasia?
4 biopsies every 2cm
It is more common for oesophageal dysplasia to progress to carcinoma in females. T/F?
False - it is more common in males
What is squamous carcinoma of the oesophagus associated with?
Smoking
Drinking
What is adenocarcinoma of the oesophagus associated with?
GORD
Obesity
What is Barrett’s oesophagus?
Metaplastic response to mucosal injury where the squamous epithelium because glandular, usually intestinal with goblet cells
What are the causes of acute gastritis?
NSAIDs
Sever trauma
Burns
Surgery
What are the causes of chronic gastritis?
Autoimmune
Bacteria (h.pylori)
Chemicals
What causes autoimmune destruction of parietal cells?
Autoantibodies against intrinsic factor and parietal cells
What chronic histological and clinical changes are seen in autoimmune destruction of parietal cells?
Complete loss of aprietal cells with pyloric and intestinal metaplasia
Achlorhydria leading to bacterial overgrowth
Hypergastrinaemia causing endocrine cell hyperplasia
What is the result of an astral predominant pattern of gastritis due to h.pylori infection?
Hypergastrinaemima and duodenal ulceration
What is the result of an pangastitis pattern of gastritis due to h.pylori infection?
Hypochlorhydria, multifocal atrophic gastritis, intestinal metaplasia, cancer
Why do 2 possible different patterns of gastritis emerge in h.pylori infection?
Due to the microbe-host interface
Which patients are more likely to get a pan gastritis in h.pylori infection?
Those with higher IL-8 production
Other than the production of too much acid, what can cause peptic ulceration?
Impaired mucosal defence (e.g. NSAIDs interfere with mucosal prostglandin synthesis) Microbe factors (CagA associated with more severe inflammation)
What are the potential complications of peptic ulceration?
Haemorrhage
Perforation
Fibrosis
What is the histological appearance of chemical gastritis?
Few inflammatory cells, surface congestion oedema, elongation of gastric puts, tortuosity, reactive hyperplasia, atypia and ulceration
What are the potential causes of chemical gastritis?
Bile reflux
NSAIDs
Ethanol
Oral iron
Gastric cancer is strongly associated with chronic gastritis. T/F?
True
What classification system is used in gastric cancer?
Lauren Classification
What is the histological appearance of diffuse gastric cancer?
Individual malignant cells with mucin vacuoles
What is the name of the tumour which is a metastasis of diffuse gastric cancer to the ovaries?
Krukenberg tumour
What is the name of the tumour which is a metastasis of diffuse gastric cancer to the supraclavicular lymph node?
Virchow’s node
What is the name of the tumour which is a metastasis of diffuse gastric cancer to the umbilica?
Sister Mary Joseph’s nodule
