wk 3 10 Pathology of Oesophagus and mouth Flashcards
epithelium of oesophagus
stratified squamous epithelium
more common - acute or chronic oesophagitis
chronic
associated with acute oesophagitis
corrosion following chemical ingestion
also can occur as an acute infection i immunocompromised pts - HIV, aids
another name for chronic oesophagitis
reflux oesophagitis
define reflux oesophagitis
inflammation due to refluxed low pH gastric content
what causes reflex oesophagitis
mostly idiopathic
big cause is obesity - increased intra-abdominal pressure (pregnancy)
other than intra-abdominal pressure, hwat can cause reflex
defectvie sphincter mechanism (hiatus hernia)
difference in epithelium of healthy - reflux
normal - dividing cells, cell desquamation
reflex - incr cell desquamation, incr cell division, immune cells
complications of reflux
ulceration (bleeding)
fibrosis
stricture - narrowing
what happens to epithelium in barrets oesophagus
replacement of stratified squamous epithelium - columnar epithelium (this type is found in sml intestine/stomach)
what causes barrets oesophagus
persistent reflux acid/bile
expansion of columnar epithelium from gastric glands/submucosal glands
due to differentiation from oesophageal stem cells
histologically, what does barrets oesophagus look like
columnar lined with mucosa with intestinal metaplasia
increased risk of developing dysplasia and carcinoma of oesophagus if the patient has
barrets - unstable mucosa, continues to damage
adenocarcinoma at junction- most likely
t/f allergic oesophagitis occurs more in females than males
false
males more
t/f allergic oesophagitis is not due to reflux
true
what does allergic oesophagitis look like
rings - similar to trachea
t/f there is a large number of intraepithelial eosinophils in allergic oesophagitis
true
likely treatment of allergic oesophagitis
treated like allergy
steroids
chromoglycate
montelukast
t/f benign oesophageal tumours are rare
true
squamous papilloma (wart like)
2 main types of malignant oesophagea; tumours
squamous cell carcinoma
adenocarcinoma (most)
which deficiencys are usually seen in squamous cell carcinoma
vit a
zinc
how does dysphagia occur in malignancy
reduces lumen to narrow slit
unable to pass food through
t/f keratin is produced by squamous cell carcinoma
true
outine pathogenesis leading to adenocarcinoma
geneticfactors/reflux/others chronic reflux barrets (intestinal metaplasia) low grade dysplasia high grade adenocarcinoma
t/f stricture indicates malignancy
false
could be benign
what are the mechanisms of metastases of oesophageal carcinoma (and many others )
direct invasion
lymphatic permeation
vascular invasion
clinical presentation of oesophagus carcinoma
dysphagia
general symptoms of lamignancy -
anaemia
weight loss/lethargy
90% of oral cancers are
squamous cell carcinomas
variable presentation of SCC oral
white red speckled ulcer lump
therapy for carcinoma oesophagis
surgery best
- adjuvant therapy (Chemo)`
