Pathoma 10.1-10.3: Gastrointestinal Pathology Flashcards
Name the diagnosis: Full-thickness defect of lip or palate; Failure of facial prominences to close.
Cleft lip and palate They usually occur together
What is the diagnosis? Painful, superficial ulceration of the oral mucosa Stress-related Grayish blue base surrounded by erythema
Aphthous ulcer
Name the diagnosis: Recurrent aphthous ulcers Genital ulcers Uveitis Immune complex vasculitis involving small vessels
Behcet’s Syndrome
Name the diagnosis: Primary infection usually occurs in childhood; Dormancy in trigeminal ganglia; vesicles in oral mucosa rupture and leave shallow ulcerations
HSV-1 (usually) - oral herpes Stress and sunlight can reactivate the virus
Name the diagnosis: Oral leukoplakia and erythroplakia are precursor lesions; Floor of mouth is common location;
Squamous cell carcinoma - malignant neoplasm of squamous cells lining oral mucosa
What is the difference between oral candidiasis and leukoplakia?
Oral candidiases can be scraped away easily. Leukoplakia cannot. The latter represents squamous cell dysplasia
What is erythroplakia?
Vascularized leukoplakia Red plaque
Name the disease: Bilateral inflamed parotid glands; Orchitis, pancreatitis, aseptic meningitis may also be present
Mumps *Serum amylase is increased due to salivary gland or pancreatic involvement
What is sialadenitis?
Inflammation of the salivary gland; Most commonly due to an obstructing stone –> staph aureus Usually unilateral
What is the diagnosis? Benign tumor composed of stromal (cartilage) and epithelial tissue; Most common tumor of the salivary gland; Arises in parotid; Mobile, painless, well-circumscribed mass at the angle of the jaw.
Pleomorphic adenoma rarely turns into carcinoma; high rate of recurrence (prob due to no excising enough)
What is the diagnosis? Benign cystic tumor with abundant lymphocytes and germinal centers; Almost always arises in the parotid
Warthin tumor 2nd most common tumor of the salivary gland
What is the diagnosis? Malignant tumor composed of mucinous and squamous cells; Most common malignancy of the salivary gland; Involves facial nerve; Usually arises in parotid
Mucoepidermoid Carcinoma
What is the diagnosis? Vomiting, polyhydraminos, abdominal distention and aspiration
Tracheoesophageal fistula Congenital defect resulting in connection between trachea and esophagues; Proximal esophageal atresia with the distal esophagus arising from the trachea - common form
What is the diagnosis? Thin protrusion of esophageal mucosa; Most often the upper esophagus; Dysphagia for poorly chewed food
Esophageal web Increased risk for esophageal squamous cell carcinoma
What is the diagnosis? Esophageal web; Beefy red tongue due to atrophic glossitis; iron-deficiency anemia
Plummer-Vinson syndrome
What is the most common cause of death in cirrhotics?
Rupture of esophageal varices Arise secondary to portal HTN; Left gastric vein backs up into the esophageal vein, resulting in dilation Asymptomatic until/unless rupture Presents with *painless* hematemesis
What is a Zenker Diverticulum?
Outpouching of pharyngeal mucosa through an acquired defect in the muscular wall; Arises above the upper esophageal sphincter (at the junction of the esophagus and the pharynx; Presents with dysphagia, obstruction, halitosis
What is the diagnosis? Longitudinal laceration of mucosa at the GE junction; Caused by severe vomiting (alcoholism, bulimia implicated here); *Painful* hematemesis
Mallory-Weiss syndrome risk of Boerhaave syndrome due to laceration: rupture of esophagus leading to air in the mediastinum and subcutaneous emphysema
Inability to relax the lower esophageal sphincter (LES) is called:
Achalasia Damaged ganglion cells in myenteric plexus; Can be idiopathic or due to Chagas disease (Trypanosoma cruzi) “Bird-beak” sign - narrowing of esophagus at sphincter, can see on barium swallow study; Presents with dysphagia, putrid breath, high LES pressure on esophageal manometry Increases risk for esophageal squamous cell carcinoma
Reduced lower esophageal sphincter tone is due to:
GERD Heartburn, asthma and cough, damage to enamel of teeth Late complications are Barrett esophagus and ulceration with stricture
What is the diagnosis? Metaplasia of lower esophageal mucosa from stratified squamous to nonciliated columnar with goblet cells
Barrett esophagus May progress to dysplasia and adenocarcinoma
What is the diagnosis? Arising from pre-existing Barrett esophagus; usually involves lower 1/3 of esophagus lymph node spread commonly celiac and gastric; Malignant proliferation of glands
Adenocarcinoma of the esophagus Most common esophageal carcinoma of the West
What is the diagnosis? Malignant proliferation of squamous cells; Usually in middle or upper third of the esophagus; Lymph node spread is cervical if upper, Mediastinal or tracheobronchial if middle; Risk factors - very hot tea, alcohol, tobacco, Plummer-Vinson syndrome, esophageal web and esophageal injury ie ingesting lye
Squamous cell carcinoma of the esophagus Most common esophageal carcinoma worldwide Presents late, poor prognosis, progressive dysphagia, weight loss, hematemesis, hoarse voice and cough
