Week 5: Esophagus Flashcards
Congenital displacement or abnormal positioning of an organ/tissue
Ectopia
ID what is occuring in the esopahgus
Ectopia
stratified squamous epithelium (open arrow) with glandular simple columnar epithelium (closed arrow), showing ectopia because the esophagus should be only squamous epithelium
ID
Esophageal Inlet patch
inlet patch (blue arrow) is an example of ectopia
is a complete rupture of esophagus caused by sudden increase in intraesophageally pressure caused by severe straining or vomiting.
Boerhaave Syndrome
is a tear of the tissue in lower esophagus often caused by violent coughing or vomiting.
Mallory-Weiss tear
ID
Boerhaave Syndrome
Will often have acute inflammation and esophageal ulcers caused by a pathogenic organism
Infectious Esophagitis
ID
Herpes Simplex Virus (HSV) infection
large squamous cells that are multinucleated, and the nuclei have a glassy appearance (yellow arrow)
Where do you take a biopsy for a GI HSV infection?
The edge of the ulcer
ID
Cytomegalovirus (CMV) infection
Very large cells in stroma (usually fibroblasts) and they have a red discoloration and sometimes halo around the nucleus (yellow arrows)
Where do you take a biopsy for a GI CMV infection?
The edge and the base of the ulcer
ID
Candidiasis infection
see the fungal hyphae in pink (yellow arrow) and non-keratinized squamous cells in purple (cyan arrow)
Presentation includes odynophagia (painful swallow) and food impaction. The esophagus can have circumferential rings. The biopsy has many eosinophils.
Eosinophilic Esophagitis
ID
Eosinophilic Esophagitis
Trachealization of the esphagus - normal in cats LOL
ID
Eosinophilic Esophagitis
Numerous eosinophils (yellow circle and arrow) and basal cell hyperplasia (cyan arrow)
How many eosinophils have to be present to classify as eosinophilic esophagitis
> 15 in a high power field
Presents with daily long-term heartburn (retrosternal burning discomfort)
Gastroesophageal reflex disease (GERD) or Reflux Esophagitis
ID
Gastroesophageal Reflux Disease (GERD) or Reflux Esophagitis
Scattered eosinophils present (yellow arrows), along with a whorled pattern (blue circles) usually with neutrophils in the whorl (orange arrow), reflecting basal cell hyperplasia and disorganized growth. Hard to diagnosis unless symptomatic and the biopsy of the upper esophagus is normal and lower is abnormal.
ID
Gastroesophageal Reflux Disease (GERD) or Reflux Esophagitis
Elongated lamina propria papilla extending >50% of the squamous thickness (yellow brackets), basal cell hyperplasia (orange arrows), and scattered inflammatory cells - eosinophil, lymphocyte, and neutrophils (cyan arrows top down).
ID the two organs
Left - Esophagus
Right - Stomach (cardia)
The squamocolumnar junction (SCJ)/Z-line is present (yellow arrows) and it is usually is accompanied by Lymphoid aggregates in the lamina propria (blue elipse) or submucosa in a normal transitional zone.
Untreated GERD may lead to development of ____ (which appears as salmon colored mucosa endoscopically and intestinal metaplasia histologically).
Barrett’s Esophagus
ID
Barrett’s Esophagus
salmon colored mucosa endoscopically (yellow arrow)
ID
Barrett’s Esophagus
Glandular replacement of stratified squamous epithelium (orange arrow) with goblet cells (yellow arrow head) and intestinal metaplasia (black arrow).
ID
Low-grade dysplasia
pallisading cells (yellow lines) and darkening of the nuclei are a key feature of low-grade dysplasia
