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PATHOLOGY > Rosai Chapter 13 - Esophagus > Flashcards

Rosai Chapter 13 - Esophagus Flashcards

1
Q

Esophagus approximately measures:

A

25 cm

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2
Q

Margin of upper esophageal sphincter

A

Cricopharyngeal muscle

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3
Q

Vertebral counterpart of the upper esophageal sphincter

A

C6

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4
Q

Measurement of upper esophageal sphincter from the incisors

A

15-18 cm

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5
Q

Margin of lower esophageal sphincter

A

Gastroesophageal junction (GEJ)

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6
Q

Measurement of lower esophageal sphincter from the incisors

A

40 cm

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7
Q

The point at which the tubular esophagus flares to the saccular stomach

A

GEJ

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8
Q

GEJ is recognized endoscopically by the:

A

proximal margin of the gastric folds

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9
Q

This is the irregular meeting point of the squamous and glandular epithelia

A

Squamocolumnar junction (SCJ)

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10
Q

SCJ is also known as:

A

“Z line”

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11
Q

SCJ or Z line will be found:

A

proximally displaced above the GEJ

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12
Q

Most common tracheoesophageal anomaly

A

Type C

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13
Q

This type of tracheoesophageal anomaly is characterized by esophageal atresia with a fistula between the lower portion of the esophagus and the respiratory tree

A

Type C

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14
Q

Most common location of heterotopic gastric mucosa

A

postcricoid region

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15
Q

other name of Heterotopic pancreatic tissue

A

Pancreatic acinar metaplasia

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16
Q

Most common type of diverticulum in the upper aerodigestive tract

A

Zenker diverticula

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17
Q

Zenker diverticula is located in the:

A

upper portion of the esophagus

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18
Q

This esophageal cysts is lined by squamous or columnar epithelium sometimes ciliated

A

Inclusion cysts

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19
Q

This esophageal cysts is arising from cystic dilation of submucosal glands

A

Retention cysts or Mucoceles

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20
Q

This esophageal cysts can be of esophageal, bronchial, or gastric origin

A

Developmental cysts

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21
Q

Component of Plummer-Vinson or Paterson-Kelly syndrome (3):

A
  • Esophageal rings and Webs
  • IDA
  • increased incidence of carcinoma
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22
Q

Esophageal rings and webs in Plummer-Vinson or Paterson-Kelly syndrome is characterized by (2):

A
  • dysphagia

- found in upper esophagus of women

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23
Q

Esophageal rings and webs located in the lower esophagus (3):

A
  • Schatzki
  • Esophagogastric
  • Lower esophageal rings
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24
Q

other name of Achalasia (2):

A
  • Cardiospasm

- Megaesophagus

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25
Q

Characteristics of Allgrove (triple A) syndrome:

A
  • Achalasia
  • Adrenal deficiency or Addisonianism
  • Alacrima
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26
Q

other name of Cricopharyngeal dysphagia (2):

A
  • Cricopharyngeal achalasia

- Cricopharyngeal spasm

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27
Q

Most common microscopic finding of Pseudoachalasia

A

Neoplastic infiltration of the myenteric plexus

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28
Q

other name of Giant muscular hypertrophy (3):

A
  • Diffuse spasm
  • Corkscrew esophagus
  • Diffuse leiomyomatosis
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29
Q

Most common location of lye strictures of the esophagus:

A

Bifurcation of the trachea

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30
Q

Microscopic hallmarks of Herpes simplex esophagitis (3):

A
  • inflammation
  • ulceration
  • Cowdry type A inclusions
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31
Q

Which of the microscopic hallmarks of herpes simplex esophagitis is not always identifiable?

A

-Cowdry type A inclusions

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32
Q

Eosinophilic (allergic) esophagitis vs.
Eosinophilic infiltration of mucosa in GERD:

-Eosinophilic microabscesses

A

Eosinophilic (allergic) esophagitis

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33
Q

Eosinophilic (allergic) esophagitis vs.
Eosinophilic infiltration of mucosa in GERD:

-Lamina propria fibrosis

A

Eosinophilic (allergic) esophagitis

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34
Q

other name of Esophagitis dissecans superficialis

A

Sloughing Esophagitis

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35
Q

Barrett esophagus segments:

LONG SEGMENT vs. SHORT SEGMENT

-Classic form

A

LONG SEGMENT

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36
Q

Barrett esophagus segments:

LONG SEGMENT vs. SHORT SEGMENT

-3 cm or more changes

A

LONG SEGMENT

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37
Q

Barrett esophagus segments:

LONG SEGMENT vs. SHORT SEGMENT

-less than 3 cm changes

A

SHORT SEGMENT

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38
Q

Intestinal type mucin:

A

MUC2

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39
Q

Gastric-type mucins (2):

A
  • MUC5AC

- MUC6

40
Q

Diagnostic features of dysplasia easily recognizable at LPO (3):

A
  • Cytoplasmic basophilia with loss of mucus
  • Nuclear hyperchromasia
  • Excessive nuclear stratification, often extending from the epithelial basement membrane to the luminal surface
41
Q

Main features used to suggest an origin for an esophageal adenocarcinoma from Barrett mucosa (2):

A
  • identification of goblet cells adjacent to the neoplasm

- epicenter of the tumor being located on the esophageal side of the GEJ

42
Q

Earliest molecular changes in Barrett esophagus (2):

A
  • Loss of CDKN2A (by deletion or hypermethylation)

- Loss of TP53 (by mutation and deletion)

43
Q

Most common tumor of the GIT in the African Bantus

A

Esophageal Squamous Cell Carcinoma

44
Q

Most common location of Esophageal SCCA:

A

-middle and lower thirds

45
Q

Main differential diagnosis in a biopsy specimen of esophageal SCCA

A

-atypical regenerative hyperplasia

46
Q

IHCs:

POSITIVE or NEGATIVE

-HMWK (CK5/6) in SCCA

A

Positive

47
Q

IHCs:

POSITIVE or NEGATIVE

-p63 in SCCA

A

Positive

48
Q

IHCs:

POSITIVE or NEGATIVE

-HMWK (CK5/6) in Adenocarcinoma

A

Negative

49
Q

IHCs:

POSITIVE or NEGATIVE

-p63 in Adenocarcinoma

A

Negative

50
Q

Term used for the carcinomas that do not invade beyond the muscularis mucosae

A

Intramucosal carcinoma

51
Q

Term used for carcinomas that do not invade beyond the submucosa

A

Superficial (or microinvasive) carcinoma

52
Q

Term used for those tumors having a lateral intramucosal spread of at least 2 cm beyond the invasive lesion

A

Superficial(ly) spreading carcinoma

53
Q

other name of Sarcomatoid carcinoma (3):

A
  • Carcinosarcoma
  • Spindle cell carcinoma
  • Polypoid carcinoma
54
Q

Most common benign tumors of the esophagus

A

Leiomyomas

55
Q

Main microscopic criteria by which leiomyosarcomas are separated from their more benign counterpart (3):

A
  • Cytologic atypia
  • Mitotic figures
  • Necrosis
56
Q

Usual predilection of Malignant Melanoma in the esophagus

A

-Lower third

57
Q

Lining of the mucosa of the esophagus

A

Stratified squamous nonkeratinized

58
Q

Mucous glands, in the lamina propria of the the distal portion of the esophagus, is also referred to as:

A

(Esophageal) Cardiac glands

59
Q

Lymph node drainage of the esophagus:

Upper third

A

Cervical nodes

60
Q

Lymph node drainage of the esophagus:

Middle third (2)

A
  • Paraesophageal nodes

- Paratracheal mediastinal nodes

61
Q

Lymph node drainage of the esophagus:

Lower third

A

Nodes around the aorta and celiac axis

62
Q

Heterotopic gastric mucosa is also referred to as:

A

(Cervical) inlet patch

63
Q

This is due to a failure of relaxation of the lower esophageal sphincter while peristaltic waves conveying foood through the esophagus reach it

A

Achalasia

64
Q

a well-recognized entity with prominent clinical symptoms but only meager microscopic findings, represented by degeneration and regeneration of the fibers of the cricopharyngeal muscle, accompanied by interstitial fibrosis

A

Cricopharyngeal dysphagia

65
Q

A motor disorder of the esophagus characterized clinically by dysphagia and pathologically by focal or diffuse hypertrophy of the muscular layer

A

Giant muscular hypertrophy

66
Q

This esophagitis should be suspected in the presence of “Volcano ulcers” at endoscopy and discrete, diffusely scattered, shallow ulcers on double-contrast esophagogram

A

Herpes simplex esophagitis

67
Q

Microscopically, the diagnosis of this esophagitis should be made when finding the typical large cells with basophilic cytoplasm and large oval, eosinophilic intranuclear inclusions, usually at the base of the ulcer

A

Cytomegalovirus (CMV) esophagitis

68
Q

This esophagitis is an endoscopically defined disease characterized by detachment of large fragments of squamous esophageal mucosa

A

Esophagitis dissecans superficialis

69
Q

This esophagitis is characterized by intraepithelial and lamina propria lymphocytosis and apoptosis of squamous cells (so-called Civatte bodies) but showing an association with viral hepatitis and HIV infection

A

Esophagitis resembling lichen planus (Lichenoid Esophagitis)

70
Q

defined as carcinoma that has penetrated through the basement membrane of the glands into the lamina propria or muscularis mucosae, but not below

A

Intramucosal carcinoma

71
Q

Definitions of AJCC TNM for squamous cell carcinoma and adenocarcinoma

T category:
Tumor cannot be assessed

A

Tx

72
Q

Definitions of AJCC TNM for squamous cell carcinoma and adenocarcinoma

T category:
No evidence of primary tumor

A

T0

73
Q

Definitions of AJCC TNM for squamous cell carcinoma and adenocarcinoma

T category:
High-grade dysplasia, defined as malignant cells confined to the epithelium by the basement membrane

A

Tis

74
Q

Definitions of AJCC TNM for squamous cell carcinoma and adenocarcinoma

T category:
Tumor invades the lamina propria or muscularis mucosae

A

T1a

75
Q

Definitions of AJCC TNM for squamous cell carcinoma and adenocarcinoma

T category:
Tumor invades the submucosa

A

T1b

76
Q

Definitions of AJCC TNM for squamous cell carcinoma and adenocarcinoma

T category:
Tumor invades the muscularis propria

A

T2

77
Q

Definitions of AJCC TNM for squamous cell carcinoma and adenocarcinoma

T category:
Tumor invades adventitia

A

T3

78
Q

Definitions of AJCC TNM for squamous cell carcinoma and adenocarcinoma

T category:
Tumor invades the pleura, pericardium, azygos vein, diaphragm, or peritoneum

A

T4a

79
Q

Definitions of AJCC TNM for squamous cell carcinoma and adenocarcinoma

T category:
Tumor invades other adjacent structures, such as the aorta, vertebral body, or airway

A

T4b

80
Q

Definitions of AJCC TNM for squamous cell carcinoma and adenocarcinoma

N category:
Regional lymph nodes cannot be assessed

A

Nx

81
Q

Definitions of AJCC TNM for squamous cell carcinoma and adenocarcinoma

N category:
No regional lymph node metastasis

A

N0

82
Q

Definitions of AJCC TNM for squamous cell carcinoma and adenocarcinoma

N category:
Metastasis in one or two regional lymph nodes

A

N1

83
Q

Definitions of AJCC TNM for squamous cell carcinoma and adenocarcinoma

N category:
Metastasis in three to six regional lymph nodes

A

N2

84
Q

Definitions of AJCC TNM for squamous cell carcinoma and adenocarcinoma

N category:
Metastasis in seven or more regional lymph nodes

A

N3

85
Q

Definitions of AJCC TNM for squamous cell carcinoma and adenocarcinoma

M category:
No distant metastasis

A

M0

86
Q

Definitions of AJCC TNM for squamous cell carcinoma and adenocarcinoma

M category:
Distant metastasis

A

M1

87
Q

Definitions of AJCC TNM for squamous cell carcinoma and adenocarcinoma

Histologic grage (G) category:
Grade cannot be assessed
A

Gx

88
Q

Definitions of AJCC TNM for squamous cell carcinoma and adenocarcinoma

Histologic grage (G) category:
Well differentiated
A

G1

89
Q

Definitions of AJCC TNM for squamous cell carcinoma and adenocarcinoma

Histologic grage (G) category:
Moderately differentiated
A

G2

90
Q

Definitions of AJCC TNM for squamous cell carcinoma and adenocarcinoma

Histologic grage (G) category:
Poorly differentiated, undifferentiated
A

G3

91
Q

This category plays a role in stage grouping of esophageal squamous cancers and is defined by the position of the epicenter of the tumor in the esophagus

A

Location

92
Q

Definitions of AJCC TNM for squamous cell carcinoma and adenocarcinoma

Location (L) category:
Location unknown

A

X

93
Q

Definitions of AJCC TNM for squamous cell carcinoma and adenocarcinoma

Location (L) category:
Cervical esophagus to lower border of azygos vein

A

Upper

94
Q

Definitions of AJCC TNM for squamous cell carcinoma and adenocarcinoma

Location (L) category:
Lower border of azygos vein to lower border of inferior pulmonary vein

A

Middle

95
Q

Definitions of AJCC TNM for squamous cell carcinoma and adenocarcinoma

Location (L) category:
Lower border of inferior pulmonary vein to stomach, including gastroesophageal junction

A

Lower

96
Q

Preferred term for a variant of squamous cell carcinoma with prominent peripheral palisading

A

Basaloid squamous cell carcinoma

PATHOLOGY (26 decks)

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