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Path - Histopath > Upper GI pathology > Flashcards

Upper GI pathology Flashcards

1
Q

what type of epithelium found Lining the BODY and ANTRUM of the stomach?

A

columnar epithelium (foveolar)

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2
Q

what does the epithelium found in the BODY and ANTRUM of the stomach secrete?

A

mucin

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3
Q

which part of the stomach contains specialised glands in the lamina propria ?

A

Body

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4
Q

which part of the stomach does NOT contain specialised glands in the lamina propria ?

A

ANTRUM

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5
Q

what is the difference between a stomach ulcer and erosion?

A

Ulcer goes through muscularis, and erosion does NOT

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6
Q

what type of epithelium found in duodenum?

what cells too?

A

Glandular epithelium

with goblet cells

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7
Q

can we find goblet cells in the stomach?

A

NO

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8
Q

which cells infiltrate of histopath films in acute oesophagitis

A

neutrophils

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9
Q

a normal oesophagus has which type of glands?

A

submucosal glands

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10
Q

what is the z line?

A

• The Z-line is the point at which the epithelium transitions from being squamous TO columnar

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11
Q

where do you tend to see H. pylori-associated gastritis ?

A

• In the pyloric antrum and pyloric canal,

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12
Q

what is the usual cause of acute oesophagitis?

A

GORD

Gastro-Oesophageal Reflux Disease

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13
Q

complications of GORD/ reflux oesophagitis?

A 
ulceration
haemorrhage
perforation
stricture
Barrett’s oesophagus
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14
Q

what is the underlying process in Barretts oesophagus?

A

metaplastic process

normal squamous epithelium of the lower oesophagus gets replaced by columnar epithelium

• This is also known as columnar-lined oesophagus (CLO)

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15
Q

when goblet cells become visible in oesophagus this is called?

A

intestinal metaplasia

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16
Q

hanges showing some of the cytological and histological features of malignancy but with no invasion through the basement membrane is known as??

A

dysplasia

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17
Q

what comes next?

Metaplasia –> Dysplasia –> _____

A

cancer/adenocarcinoma (BM invasion)

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18
Q

which oesophageal carcinoma is associated with reflux?

which type of countries is this found?

A

adenocarcinoma

in Developed Countries

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19
Q

where does oesophageal adenocarcinoma typically present?

A

lower oesophagus

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20
Q

which is the commonest oesophageal cancer in Developing Countries?

which region of oesophagus

A

Squamous Cell Carcinomaof the oesophagus

mid/lower

21
Q

difference between Adeno and SCC of oesophagus?

A

Squamous cell cancers make keratin

and intercellular bridges

on histology

22
Q

cause of ACUTE Gastritis?

A

Infection; h.pylori

Chemical; NSAIDs, alcohol, aspirin etc

23
Q

what is the ABC of chronic gastritis?

A

Autoimmune, Bacteria, Chemical

Autoimmune (antiparietal antibodies etc. BODY)
Bacterial (H. pylori; Antrum )
Chemical (NSAIDs, bile reflux; antrum )

Metabolic disease is NOT a cause of chronic gastritis (so not alcohol)

24
Q

which part of the stomach does h. pylori attack?

A

antrum

25
Q

which part of the stomach does bile reflux affect ?

A

antrum

26
Q

what does it mean If you see lymphoid follicles in a stomach biopsy?

A

the patient has had an H. pylori infection (i.e. the presence of lymphoid follicles is NOT part of the normal stomach mucosa)

27
Q

Mucosa Associated Lymphoid Tissue (MALT) is found in which condition?

A

chronic gastritis

28
Q

MALT increases the risk of?

A

lymphoma

29
Q

Consequences of H. pylori associated gastritis?

A

CLO –> IM –> Dysplasia
Adenocarcinoma (8 x increased risk)
Lymphoma (MALToma)

30
Q

which strain o bacteria is associated with more chronic inflammation?

A

cag-A-positive H.pylori

31
Q

the Metaplasia-Dysplasia Pathway leads to cancer where?

A

§ E.g. oesophageal cancer

32
Q

the Adenoma-Carcinoma pathway leads to cancer where?

A

colon cancer

33
Q

hronic ulcers are accompanied by ??

A

scarring and fibrosis

34
Q

is Gastric Epithelial Dysplasia malignant?

A

• Some of the cytological and histological features of malignancy are present, but there is no invasion through the basement membrane

35
Q

> 95% of all malignant tumours in the stomach are ?

A

ADENOCARCINOMAS

36
Q

gastric cancers are present in which 2 forms?

A

intestinal

diffuse - poor differentiatoin

37
Q

overall survival rate of gastric cancers is?

A

15%

38
Q

name a LOW GRADE B CELL LYMPHOMA in stomach?

A

Gastric MALToma / Lymphoma

39
Q

how to treat a gastric maltoma?

A

If limited to the stomach and H.pylori is present: H.pylori eradication

40
Q

what is duodenitis?

A

Increased acid production in the stomach which spills over into duodenum causing
Chronic inflammation

41
Q

consequences of duodenitis?

A
  1. gastric metaplasia ;

Duodenum changes to gastric type tissue making it vulnerable to helicobacter (2)

  1. hence ulcer
42
Q

duodenal ulcers are benign/malignant?

what inflame cells seen?

A

benign

neutrohphils

43
Q

Name 2 IMPORTANT pathogens affecting the duodenum?

A

Giardiasis
Whipple’s disease (Tropheryma whippelii)

○ CMV - like stomach
○ Cryptosporidium - like stomach

44
Q

what histological features seen in coealics?

A

○ Villous atrophy - also flattening!
○ Crypt hyperplasia
○ Increased intraepithelial lymphocytes
§ Normal Range: < 20 per 100 enterocytes

45
Q

2 antibody present in coeliacs?

A

endomysial antibodies and

tissue transglutaminase antibodies (TTG)

46
Q

when would a coeliac patient villi look normal?

A

*stopped gluten due to side effects so their villi may look normal.

47
Q

Patients with coeliac disease have an increased risk of which cancers?

A

MALToma
• These are T cell lymphomas

EATL:
Enteropathy Associated T-cell Lymphoma

	○ NOTE: lymphomas in the stomach due to H. pylori are B cell lymphomas
48
Q

in the stomach, there are NO crypts of Leiberkhun or just crypts as such. what is the gastric equivalent and where are they found?

A

gastric pits

found just underneath the villi -> in the lamina propria

which either conatain specialised/Non-specialised glands

49
Q

signet ring cells are found in?

A

Gastric cancers (adenocarcinoma)

particularly the diffuse poorly differentiated ones

Path - Histopath (21 decks)

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