Upper GI Flashcards
Benign mimics of malignancy oesophagus
pseudoepitheliomatous hyperplasia (look for granular cell tumour)
CMV/HSV
radiation
Spindle cell tumours (oesophagus and stomach)
Oesophagus: granular cell tumour, leiomyoma
Stomach: GIST, schwannoma, glomus tumour, plexiform fibromyxoma, Kaposi sarcoma, inflammatory fibroid polyp
Common oesophageal infections
Candida
Herpes
CMV
Non-infectious oesophagitis (7)
reflux
eosinophilic
corrosive
pill-induced
radiation
Crohn’s
GVHD
Infectious gastritis
Immunocompetent: H pylori
Immunosupressed: CMV, HSV, cryptosporidium, MAIC, Whipples
Infectious duodenitis
Whipple disease (Tropheryma)
Giardia
Strongyloides
DDX coeliac disease (7)
other food allergy
tropical sprue
infection
drugs
common variable immunodeficiency
inflammatory bowel disease
Zollinger-Ellison
autoimmune vs Helicobacter-assoc gastritis
AI: deep inflammation without lymphoid follicles or active inflammation (clinical: anaemia/IF antibodies)
Helicobacter: superficial active inflammation with deep lymphoid follicles, giemsa/IHC
atrophic gastritis (DDX)
autoimmune
multifocal atrophic Helicobacter
chronic gastritis vs MALT
MALT: needs clusters of 3 or more lymphocytes in epithelium (gastritis usually single cells)
GIST prognosis
Size (cm) -2-5-10-
Mitoses (/10HPF) -5-
Tables for risk of progression
Benign mimics of malignancy stomach
xanthelasma (PAS-), Whipples, MAIC (all mimic diffuse ca)
Oesophageal glandular epithelium
intestinal metaplasia/Barretts (goblet cells)
inadvertent gastric/junctional mucosa
heterotopic gastric mucosa
embryological remnant (ciliated)
sebaceous glands
Barretts (definition)
- columnar epithelium at endoscopy
- AB+ goblet cells on histology (NB ‘columnar blue cells’ and PAS only goblet cells insufficient)
NB: goblet cells not required in Britain and Japan (considered sampling error)
