XV - The Oral Cavity and the GI Tract Flashcards
Aphthous ulcers (canker sores)(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 580
Small, painful, rounded superficial erosions of the mouth, covered with a gray-white exudate and having an erythematous rim.
Herpetic stomatitis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 580
Extremely common infection caused by herpes simplex virus type 1.
Tzanck test(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 580
Test used to identify HSV infection.
Herpes simplex virus(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 580
Glassy, intranuclear acidophilic inclusion bodies. SEE SLIDE 15.1.
Oral candidiasis /”thrush”(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 581
Adherent white, curd-like, circumscribed plaque within the oral cavity. The pseudomembrane can be scraped off revealing an underlying granular erythematous inflammatory base.
Hairy leukoplakia(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 581
An oral lesion seen in patients with HIV. White confluent patches with “hairy” or corrugated surface with marked epithelial thickening.
Epstein-Barr virus(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 581
Hairy leukoplakia is caused by what infectious agent?
Leukoplakia(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 581
A whitish, well-defined mucosal patch or plaque caused by epidermal thickening or hyperkeratosis, commonly seen in the vermillion border of the lower lip, buccal mucosa, hard and soft palates.
Verrucous leukoplakia(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 582
Oral lesion showing a corrugated surface caused by excessive hyperkeratosis. Recurring and spreads insiduously, resulting in a warty-type lesion.
Erythroplakia(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 582
Red, velvety, granular, circumscribed lesions of the mouth with poorly defined, irregular boundaries. High malignant transformation rate.
Vermillion border of the lateral margins of the lower lip(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 582
Most frequent site of oral cavity carcinomas.
Oral cavity carcinoma(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 583
Pearly white to gray, circumscribed thickenings of the oral mucosa, which grows in exophytic pattern to produce a visible and palpable nodular, eventually fungating lesions.
Mucocele(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 583
Most common lesion of the salivary glands resulting from blockage or rupture of a salivary gland duct.
Sialadenitis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 583
Inflammation of the salivary glands.
Mikulicz syndrome(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 583
Salivary and lacrimal gland inflammatory enlargement presenting as painless lesions, and dry mouth. Can be caused by sarcoidosis, leukemia, and lymphoma.
Achalasia(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 585
Incomplete relaxation of lower esophageal sphincter in response to swallowing.
Chagas disease(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 585
Destruction of the myenteric plexus of the esophagus, duodenum, colon and ureter caused by a flagellate protozoa.
Trypanosoma cruzi(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 585
Causative agent for Chagas disease.
Stenosis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 585
Adult with progressive dysphagia to solids and eventually to all foods, caused by a narrowing of the lower esophagus, usually as a result of chronic inflammatory disease.
Esophageal atresia(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 585
A congenital defect which causes the esophagus to end in a blind-ended pouch.
Esophageal atresia with distal tracheoesophageal fistula(Type C)(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 585
Most common type of esophageal atresia.
Esophageal web(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 585
Thin membranes of normal esophageal tissue consisting of mucosa and submucosa that can partially obstruct the esophagus.
Middle and inferior third of the esophagus(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 585
Congenital esophageal webs commonly appear in which segment of the esophagus?
Zenker’s diverticulum(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 586
A diverticulum of the mucosa of the pharynx just above the cricopharyngeal muscle.
Killian’s triangle(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 586
A triangular area in the pharyngeal wall where a Zenker’s diverticulum may develop.
Sliding hernia(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 586
Protrusion of the stomach above the diaphragm, creating a bell-shaped dilation, bounded below by the diaphragmatic narrowing.
Paraesophgeal (rolling) hernia(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 586
Hernia wherein a portion of the stomach, usually along the greater curvature, enters the thorax through the widened space between the muscular crura.
Mallory-Weiss tears(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 586
Longitudinal tears along the gastroesophageal junction seen in chronic alcoholics after a bout of retching or vomiting.
Esophageal varices(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 587
Tortuous dilated veins lying within the submucosa of the distal esophagus and proximal stomach due to increased portal pressure, usually due to cirrhosis. May cause massive hemorrhage if ruptured.
Reflux esophagitis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 588
Presence of eosinophils in the epithelial layer, basal zone hyperplasia and elongation of lamina propria papillae are histologic findings in this condition.
Barrett esophagus(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 591
Defined as the replacement of the normal distal stratified squamous mucosa by metaplastic columnar epithelium containing goblet cells. A complication of long-standing GERD. SEE SLIDE 15.2.
Barrett esophagus(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 589
Esophageal lesion at risk of developing adenocarcinoma:Reflux esophagitis or Barrett esophagus?
Proximal 2/3 of the esophagusAdenocarcinoma- distal 1/3(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 591
Squamous cell carcinoma of the esophagus commonly occur at which segment of the esophagus?
Dysphagia and odynophagia(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 591
Most common symptoms of esophageal cancer.
Adenocarcinoma of the esophagus(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 591
Mucin-producing glandular tumors of the distal esophagus showing intestinal-type features. SEE SLIDE 15.3.
Chronic gastritis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 592
Presence of chronic inflammatory changes in the mucosa of the stomach eventually leading to mucosal atrophy and epithelial metaplasia.
Helicobacter pylori(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 592
Most important etiologic association with chronic gastritis. A non-invasive, non-spore forming S-shaped gram negative rod.
Autoimmmune gastritis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 592
Gastritis resulting from production of autoantibodies to the gastric gland parietal cells, leading to gland destruction and mucosal atrophy with loss of acid and intrinsic factor.
Intestinal metaplasia(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 592
Refers to the replacement of gastric epithelium with columnar and goblet cells of intestinal variety.
Acute gastritis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 593
A acute mucosal inflammatory process of the stomach, marked by mucosal edema and inflammatory infiltrate of neutrophils and chronic inflammatory cells. Regenerative replication of cells in the gastric pit is prominent.
Acute gastritis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 593
One of the major causes of hematemesis, especially in alcoholics.
Ulcers(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 593
A breach in the mucosa that extends through the muscularis mucosae into the submucosa or deeper.
Erosions(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 593
Breach in the epithelium of the gastrointestinal mucosa only.
Peptic ulcers(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 594
Chronic, solitary lesions that occur in any portion of the GIT exposed to the aggressive action of acidic peptic juices.
NSAID use(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 595
Major cause of peptic ulcer disease in patients without H. pylori disease.
From luminal surface:NecrosisInflammationGranulation tissueScar(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 596
Histologic layers in a chronic, nonperforated, open ulcer.
Bleeding(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 596
Chief complication of peptic ulcer.
Acute gastritisPUD is NOT a premalignant lesion(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 596
Increases risk of developing gastric adenocarcinoma:Acute gastritis vs. peptic ulcer disease?
Curling ulcer(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 596
Acute gastric ulceration which occurs in the presence of extensive burns.
Cushing ulcer(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 596
Acute gastric ulceration which occurs in the presence of injury to the CNS.
Gastric polyp(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 597
Composed of hyperplastic gastric mucosal epithelium and an inflamed edematous stroma. A mass lesion arising from the mucosa.
Pylorus and antrum (50-60%), along the lesser curvatureCardia (25%)(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 598
Most common site of gastric carcinoma within the stomach.
Focal weakness in the colonic wall and increased intraluminal pressure(TOPNOTCH)
What are the two most important factors in the genesis of colonic diverticula?
Depth of invasion(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 599
Morphologic feature of gastric carcinomas with greatest impact on prognosis.
Early gastric carcinoma(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 599
Gastric carcinoma confined to the mucosa and submucosa, regardless of the presence or absence of perigastric LN metastasis.
Advanced gastric carcinoma(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 599
Gastric carcinoma which has extended below the submucosa into the muscular wall.
Exophytic - protrusion of mass into lumenFlat or depressed - no obvious tumor mass within the mucosaExcavated - a shallow or deeply eroded crater(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 599
Three macroscopic growth patterns of gastric carcinoma.
Linitis plastica(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 599
Rigid and thickened stomach, secondary to extensive malignant infiltration.
Intestinal variant gastric adenocarcinoma (TOPNOTCH)Robbins Basic Pathology, 9th Ed p. 570
Histologic classification of gastric carcinoma composed of malignant cells forming neoplastic intestinal glands resembling colonic adenocarcinoma. Associated with H. pylori induced chronic gastritis. SEE SLIDE 15.4.
Diffuse variant gastric adenocarcinoma (TOPNOTCH)Robbins Basic Pathology, 9th Ed p. 570
Histologic classification of gastric carcinoma composed of gastric-type mucous cells that do not form glands but permeate the mucosa and wall as “signet-ring” cells in an infiltrative growth pattern. Often evoke a desmoplastic reaction that may cause leather bottle appearance (linitis plastica). SEE SLIDE 15.5.
Krukenberg tumor(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 599
A malignancy in the ovary that metastasized from a gastric adenocarcinoma.
Atresia(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 600
Complete failure of development of the intestinal lumen.
Stenosis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 600
Narrowing of the intestinal lumen with incomplete obstruction.
Meckel diverticulum(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 600
Most common intestinal anomaly which results from the failure of involution of the omphalomesenteric duct, leaving a persistent blind-ended tubular protrusion as long as 5-6cm.
Omphalocoele. SEE SLIDE 15.6. (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 600
A congenital defect of the periumbillical abdominal musculature that creates a membranous sac, into which intestines herniate.
Gastroschisis. SEE SLIDE 15.6. (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 600
Extrusion of the intestines caused by lack of formation of a portion of the abdominal wall.
Malrotation(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 600
Condition that prevents the intestines from assuming their normal intra-abdominal positions.
Lack of ganglion cells in the muscle wall and submucosa of the affected segment.(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 601
Critical lesion in the development of Hirschprung disease.
Mucosal infarction(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 601
Ischemic lesion of the intestines which extends only up to the muscularis mucosae.
Mural infarction(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 601
Ischemic lesion of the intestines involving the mucosa and submucosa, sparing the muscular wall.
Transmural infarct(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 601
Ischemic lesion of the intestines involving all of the visceral layers.
Acute occlusion of a major mesenteric artery(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 602
Most common cause of transmural infarction of the intestines.
Ischemic bowel injury(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 602
Development of sudden abdominal pain out of proportion to the physical signs. Sometimes accomplanied by bloody diarrhea. May progress to shock and vascular collapse within hours.
Hernia(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 603
A weakness or defect in the wall of the peritoneal cavity, which permits protrusion of a pouch-like serosa lined sac of peritoneum.
Diverticula(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 602
A blind pouch that communicates with the lumen of the gut. Histologically describes as small, flask-like or spherical outpouchings, usually 0.5 to 1 cm diameter.
Intussusception(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 604
Telescoping of a proximal segment of a bowel into the immediately distal segment
Volvulus(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 604
Refers to twisting of a loop of bowel or other structure about its base of attachment, constricting venous outflow and sometimes the arterial supply.
Crohn’s disease(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 613
Characterized by transmural inflammation of the bowel, associated with noncaseating granulomas and fistula formation. Intestinal walls are rubbery and thick. SEE SLIDE 15.7. (+) skip lesions, creeping fat mesentery
Ulcerative colitis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 614
An ulceroinflammatory disease of the colon which is limited to the mucosa and submucosa. No granulomas, no skip lesions. High risk of carcinoma development. SEE SLIDE 15.8.
Hyperplastic polyps(TOPNOTCH)Robbins Basic Pathology, 9th Ed p. 593
Small, nipple-like, hemispherical, smooth protrusions of the intestinal mucosa. Contains abundant crypts lined by well-differentiated goblet or epithelial cells, giving a SERRATED surface architecture. SEE SLIDE 15.9.
Juvenile polyps(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 618
Hamartomatous proliferations mainly of lamina propria, enclosing widely spaced, dilated cystic glands. Occur most frequently in children younger than 5 years old. SEE SLIDE 15.10.
Tubular adenomas. SEE SLIDE 15.11. (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 618
Most common type of intestinal adenoma, which are tubular glands with slender stalks and raspberry-like heads composed pf neoplastic epithelium forming branching glands lined by tall, hyperchromatic cells.
Villous adenomas. SEE SLIDE 15.11. (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 618
Larger, more ominous intestinal epithelial polyp. Tends to occur in older persons at the rectum or rectosigmoid. Sessile, velvety and cauliflower-like mass projecting 1-3cm above the surrounding mucosa. Frondlike villiform extensions covered by dysplastic columnar epithelium.
Tubulovillous adenomas(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 618
Composed of broad mix of tubular and villous areas, an intermediate between tubular and villous lesions.
Familial adenomatous polyposis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 619
Uncommon autosomal dominant disorder with propensity for malignant transformation. Patients with this disease typically develop 500 to 2500 colonic adenomas that carpet the mucosal surface.
Peutz-Jeghers syndrome(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 619
Uncommon hamartomatous polyps associated with melanotic mucosal and cutaneous pigmentation. SEE SLIDE 15.12. Caused by germ-line mutations in LKB1 gene.
Right sided colorectal carcinoma(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 623
Polypoid, exophytic masses that extend along the wall of capacious cecum and ascending colon. Symptoms of fatigue, weakness and iron deficiency anemia.
Left-sided colorectal carcinoma(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 623
Annular, encircling lesions, “napkin-ring” constrictions of the bowel and narrowing of the lumen. Symptoms pf occult bleeding, changes in bowel habit or crampy left lower quadrant discomfort.
Gastrointestinal stromal tumors (GIST)(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 628
Tumor of the small intestines, showing spindle cells with elongated nuclei with fine chromatin and eosinophilic fibrillar cytoplasm. (+) c-KIT gene mutation. SEE SLIDE 15.13.
Small intestine(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 774
Most common site of carcinoid tumors.
Carcinoid tumors(TOPNOTCH)Robbins Basic Pathology, 9th Ed p. 571
Tumors arising from endocrine cells along the GIT. Solid, yellow-tan appearance on transection. Nmay also cause a desmoplastic reaction that may cause kinking of bowel and obstruction. Histology shows islands, trabeculae, strands, or sheets of uniform cells with scant, pink granular cytoplasm, with a stippled nucleus. SEE SLIDE 15.14.
Ectopic Gastric Mucosa seen in the upper third of the esophagus (TOPNOTCH)
What is the most common ectopic tissue rests seen in the esophagus?
Esophagogastric junction or in the proximal gastric (TOPNOTCH)
What is the most common location of Mallory Weiss Tears?
Intestinal Goblet Cells(TOPNOTCH)
Definitive diagnosis of Barret Esophagus is made when what type of cells is seen in the columnar mucosa?
CMV esophagitis. SEE SLIDE 15.15. (TOPNOTCH)
What type of esophagitis presents with linear ulcerations of the esophageal mucosa with histologic findings of intranuclear and cytoplasmic inclusions?
First portion of the anterior part of the duodenum(TOPNOTCH)
98% of Peptic Ulcers are located in what part of the GIT?
Lesser curvature (TOPNOTCH)
What is the most common location of gastric ulcer?
Pylorus and antrum > Cardia > body and fundus(TOPNOTCH)
What is the most common location of gastric carcinoma is?
Depth of invasion(TOPNOTCH)
What is the morphologic feature of gastric carcinoma that has the greatest impact on the clinical outcome?
Systemic lymphoma(TOPNOTCH)
What is the most common primary source of gastric metastasis?
E. coli(TOPNOTCH)
What is the usual organism that cause spontaneous bacterial peritonitis in patients with nephrotic syndrome?
2-4 hours(TOPNOTCH)
In bacterial peritonitis, approximately how many hours from the time of initiation before there is loss of the gray, glistening quality of the peritoneal surface and it becomes dull and lusterless?
Presence of neutrophilic infiltration of the muscularis propria.(TOPNOTCH)
What is the histologic criterion for the diagnosis of acute appendicitis?
The extent of the tumor at the time of diagnosis or the stage(TOPNOTCH)
What is the most important prognostic indicator of colorectal carcinoma?
Inflammatory or pseudopolyps(TOPNOTCH)
These structures represent islands of inflamed regenerating mucosa surrounded by ulceration
Ampulla of Vater(TOPNOTCH)
Most adenomas are seen in what part of the GIT?
Colon(TOPNOTCH)
Most tubular adenomas are found in what part of the GIT?
Colonic diverticula(TOPNOTCH)
Morphology: thin wall composed of flattened or atrophic mucosa, compressed submucosa, and attenuated or totally absent muscularis propria.
Cecum(TOPNOTCH)
What is the most common site of angiodysplasia?
Angiodysplasia(TOPNOTCH)
Morphology: these are tortuous dilations of submucosal and mucosal blood vessels
Splenic flexure(TOPNOTCH)
What area of the GIT is at greatest risk of ischemic injury?
Ulcerative Colitis(TOPNOTCH)
Morphology: diffuse active inflammation with crypt abscess and glandular architectural distortion
Focal neutrophilic infiltration into the epithelial layer, particularly overlying mucosal lymphoid aggregates(TOPNOTCH)
What is the earliest lesion seen in Crohn Disease?
Chronic mucosal damage(TOPNOTCH)
What is the hallmark of inflammatory bowel disease, both CD and UC?
Crohn disease(TOPNOTCH)
Gross morphology: narrowing of lumen, bowel wall thickening, serosal extension of mesenteric fat, and linear ulceration of the mucosal surface
Strong immune response against normal flora and defects in epithelial barrier function(TOPNOTCH)
What are the two key pathogenic abnormalities seen in Idiopathic Inflammatory Bowel disease?
Crohn disease(TOPNOTCH)
Gross morphology: intestinal wall is rubbery and thick, as a consequence of edema, inflammation, fibrosis and hypertrophy of the muscularis propria
Whipple disease(TOPNOTCH)
Morphology: Small intestinal mucosa laden with distended macrophages in the lamina propria which are PAS positive and contains numerous bacilli and diastase resistant granules. SEE SLIDE 15.16.
Whipple disase(TOPNOTCH)
Intestinal lipodystrophy is associated with what disease entity?
Celiac disease. SEE SLIDE 15.17. (TOPNOTCH) Robbins Basic Pathology, 9th ed. P 578.
Disease associated with GLUTEN intake, often affects second portion of duodenum or proximal jejunum. There is increased lymphocytosis and diffuse severe atrophy and blunting of villi.
Acute GVHD(TOPNOTCH)
Morphology: focal crypt cell necrosis or apoptosis with minimal to absent inflammatory cell response in the lamina propria
Giardiasis(TOPNOTCH)
Morphology: Marked blunting of the small intestinal villi with a mixed inflammatory infiltrate resembling the atrophic stage of celiac disease
Pseudomembranous colitis(TOPNOTCH)
Morphology: Superficial erosion of the mucosa and an adherent pseudomembrane of fibrin, mucus, and inflammatory debris. SEE SLIDE 15.18.
Viral gastroenteritis(TOPNOTCH)
Morphology: Small intestinal mucosa usually exhibits modestly shortened villi and infiltration of the lamina propria by lymphocytes
Rotavirus(TOPNOTCH)
What virus affecting the GIT can produce a flat mucosa resembling celiac sprue?
Hirchsprung Disease/Congenital Aganglionic Megacolon(TOPNOTCH)
Morphology: Characterized by the absence of ganglion cells and ganglia in the muscle wall and submucosa of the affected segment
Hirchsprung Disease/Congenital Aganglionic Megacolon(TOPNOTCH)
Stercoral ulcers are seen in what disease entity?
Gastrointestinal Stromal Tumor(TOPNOTCH)
The majority of these tumors are positive for c-KIT (CD 117)
Pylorus and antrum 50%-60%(TOPNOTCH)
What is the most common site of gastric carcinoma?
Lesser curvature of the anthropyloric region(TOPNOTCH)
What is the most favored site of gastric carcinoma?
Hyperplastic polyp(TOPNOTCH)
What is the most common type of gastric polyp?
Presence of neutrophils above the basement membrane.(TOPNOTCH)
In gastritis, histologically, what signifies an active inflammation?
Virtually ALL (70% in patients with gastric ulcer(TOPNOTCH)
H. pylori infection in duodenal ulcers is present in about how many percent of patients?
Meckel Diverticulum (TOPNOTCH)
A 10 y/o male presented with recurrent painless rectal bleeding with no other associated symptoms. PE findings were unremarkable. The abdomen was soft, non tender, with no palpable mass. What is the clinical impression?
Antimesenteric border of ileum (TOPNOTCH)
Most common site of Meckel Diverticulum
True (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 751
True or False. Meckel diverticulum is a true diverticulum
Sigmoid colon (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 751
Most common site of acquired diverticula.
Meckel Diverticulum (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 751
The most common true diverticulum
Pyloric stenosis (TOPNTOCH)
A 3 week old male infant presented to the ER due to vomiting. Mother denies bilious or bloody emesis. Mother states he is always hungry and vomits after nearly every bottle. PE reveals firm, ovoid, 2 cm abdominal mass. What is the most likely diagnosis?
Hyperplasia of pyloric muscularis propria (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 751
Pathology of Pyloric stenosis
3-5x more common in male (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 751
Pyloric is more common in male or female?
Hirchsprung’s Disease (TOPNOTCH)
A 3-day-old infant presented with emesis and failure to pass meconium for the first 36 hours. PE revealed a moderately distended abdomen. Bowel sound are active. No organs or abdominal masses were palpated. Anus was patent. What is the clinical impression?
Rectal biopsy (TOPNOTCH)
Most important diagnostic test in Hirchsprung Disease
Absence of ganglion cells in the submucosal and myenteric plexuses.(and hypertrophic extrinsic nerve fibers) (TOPNOTCH)
Histologic findings in Hirchsprung Disease
Hirchsprung’s Disease(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 752
Typically presentes with failure to pass mecondium in the immediate postnatal period, followed by obstruction or constipation, often with visible ineffective peristalsis, progressing to abdominal distention and bilious vomiting.
Upper third of esophagus (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 750
Most frequent site of ectopic gastric mucosa
Grossly normal or contracted appearance. Normal proximal colon-dilated. (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 752
Aganglionic segment of the colon presents with distention or contracted appearance?
Zenker diverticulum (TOPNOTCH)
Dysphagia, regurgitation of undigested food, aspiration, and halitosis strongly suggest diagnosis of ______.
Achalasia(TOPNOTCH) Robbins Basic Pathology, 9th ed., p.753
It is characterized by the triad of incomplete LES relaxation, increased LES tone, and aperistalsis of the esophagus
Impaired smooth muscle relaxation of LES (Case of Achalasia) (TOPNOTCH)
Patient presented with dysphagia for both solid and liquid, difficulty in belching, and chest pain. The esophageal obstruction is most likely caused by?
Primary achalasia (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 753
It is the result of distal esophageal inhibitory neuronal/ganglion cell degeneration.
Boerhaave syndrome. (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 754
Characterized by transmural tearing and rupture of the distal esophagus. Patients present with severe chest pain, tachypnea and shock.
Reflux of gastric contents in the lower esophagus. (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 755
Most frequent cause of esophagitis
Transient lower esophageal sphincter relaxation. (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 755
Most common cause of gastroesophageal reflux
GERD (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 561
Severe form of this condition may have histologic finding of eosinophils recruited into the squamous mucosa followed by neutrophils. Basal zone hyperplasia and elongation of lamina propria papillae of the esophagus may be present.
Esophageal adenocarcinoma (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 757
Barrett esophagus confers an increased risk of what cancer?
Esophageal adenocarcinoma. This is a case of Barret esophagus. (TOPNOTCH)
A 55 y/o patient with a chronic history of heartburn and acid regurgitation underwent EGD, and revealed patches of red, velvety mucosa with interface of light-brown columnar epithelium with goblet cells. He is at risk for developing___.
Esophageal adenocarcinoma. It usually occurs in the distal 3rd of esophagus. (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 758
Patient presented with odynophagia, dysphagia, progressive weight loss, chest pain and vomiting. A 5 cm mass was noted at the distal 3rd of the esophagus, which ulcerate and invade deeply. The most likely diagnosis is
Sigmoid colon(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 778
Most common site of volvulus
Intussusception(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 778
Most common cause of intestinal obstruction in children younger than 2 years of age
Acute colonic ischemia(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 780
Presents with sudden onset of cramping, left lower abdominal pain, a desire to defecate, and passage of blood or bloody diarrhea.
Necrotizing enterocolitis(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 780
Most common acquired GI emergency of neonates, particularly those who are premature or of low birth weight.
Celiac disease/Celiac sprue/Gluten-sensitive enteropathy(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 782
Immune-mediated enteropathy triggered by ingestion of gluten-containing food in genetically predisposed individual
IgA antibodies against tissue transglutaminase(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 783
Most sensitive test for Celiac sprue
Campylobacter jejuni(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 786
Most common bacterial enteric pathogen; an important cause of traveler’s diarrhea
Campylobacter enterocolitis(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 786
Watery diarrhea associated with ingestion of improperly cooked chicken, unpasteurized milk or contaminated water. It is an important bacterial cause of food poisoning.
Stool culture(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 787
Diagnosis of Campylobacter enterocolitis, stool culture or biopsy?
Shigellosis(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 787
Presents with 1 week of diarrhea, fever, and abdominal pain, constitutional symptoms for about 1 month. May also present with waxing and waning diarrhea. Caused by gram-negative, facultative anaerobe.
Sterile reactive arthritis, urethritis, and conjunctivitis.(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 788
Complications of Shigella infection(Triad)
Salmonella(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 789
Infection by a gram-negative bacilli causing diarrhea, common in young children and older adults by ingestion of contaminated food, particularly raw or undercooked meat, poultry, eggs, and milk.
Salmonella(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 789
Patients with sickle cell disease are particularly susceptible to osteomyelitis caused by:
Enterotoxigenic E. Coli(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 790
The principal cause of traveler’s diarrhea
Cholera(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 785
Mechanism of diarrhea in this infection : adenylate cyclase activation, increase intracellular cAMP, opens CFTR to drive chloride secretion and diarrhea.
Clostridium difficile(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 791
Most common etiologic agent causing pseudomembranous colitis/antibiotic-associated colitis.
Bleeding(TOPNOTCH)Robbins Basic Pathology, 9th Ed p. 768
Most frequent complication of Peptic ulcer disease
Autoimmmune gastritis(TOPNOTCH)Robbins Basic Pathology, 9th Ed p. 768
Most frequent etiology of noninfectious chronic gastritis
Menetrier disease(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 768
Characterized by irregular enlargement of gastric rugae associated with excessive secretion of TFG-alpha.
Zollinger-Ellison Syndrome(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 769
Syndrome most commonly found in the small intestine or pancreas, caused by gastrin-secreting tumors; most remarkable feature is doubling of oxyntic mucosal thickness
Antrum(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 770
Most common site of gastric adenoma in the stomach
Adenocarcinoma(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 771
Most common malignancy of the stomach
Intestinal-type gastric cancer(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 772
Most common type of cancer the predominates in high-risk areas and develops from flat dysplasia and adenomas
Stomach(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 773
Most common site of extranodal lymphoma
H. pylori(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 773
Most common inducer of MALToma in the stomach
Carcinoid tumor(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 774
GI Tumor characterized by cutaneous flushing, sweating, bronchospasm, colicky abdominal pain, diarrhea, and right-sided cardiac valvular fibrosis.
GI stromal tumor(GIST) tumor(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 775
The most common mesenchymal tumor of the abdomen
Location(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 775
The most important prognostic factor for GI Carcinoid tumor
Stomach(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 777
Most common site of GIST
Hernias(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 777
Most frequent cause of intestinal obstruction
Splenic flexure, sigmoid colon, rectum(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 784
Most common sites of ischemic bowel disease
Congenital lactase (disaccharidase) deficiency(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 784
Autosomal recessive disorder presenting with explosive diarrhea with watery, frothy stools, and abdominal distention.
Crohn disease(TOPNOTCH)Robbins Basic Pathology, 9th ed., . 797
IBD presenting with thick wall appearance, transmural inflammation, skip lesions, knife-like ulcer, marked fibrosis and serositis
Ulcerative colitis(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 797
IBD which may presents with thin wall appearance, inflammation limited only to mucosa, marked pseudopolyps, broad-based ulcer, moderate lymphoid reaction, and toxic megacolon (complication)
Size of the tumor(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 808
Most important characteristic of colorectal adenomas that correlates with risk of malignancy.
Familial adenomatous polyposis(TOPNOTCH)Robbins Basic Pathology, 9th Ed p. 809
An autosomal dominant disorder in which patients develop numerous colorectal adenomas as teenager caused by mutation of APC
HNPCC or Lynch syndrome(TOPNOTCH)Robbins Basic Pathoogy, 9th ed., p. 809
Most common syndromic form of colon cancer; colon cancers tend to occur at younger ages
Right colon(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 809
Most common location of HNPCC
HNPCC or Lynch syndrome(TOPNOTCH)Robbins Basic Pathoogy, 9th ed., p. 809
Autosomal dominant disorder characterized by familial clustering of cancers at several sites caused by DNA mismatch repair
Right-sided colorectal carcinoma(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 623
Location of colorectal cancer presenting with fatigue and weakness due to iron deficiency anemia
Liver(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 813
Most common site of metastasis of colorectal adenocarcinoma
leukoplakia has a strong association with tobacco use (TOPNOTCH)Robbins Basic Pathology, 8th Ed pp 581-82
Which of the following statements regarding oral plaques is TRUE? (A) leukoplakia has a strong association with tobacco use (B) among the oral leukoplakias, those on the floor of the mouth have the highest rate of transformation to squamous cell carcinoma (C) hairy leukoplakia in AIDS patients have a high risk of malignant transformation (D) erythroplakia is less likely to undergo malignant transformation than leukoplakia
Vermillion border of the lateral margins of the lower lip(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 582
Which of the following is the most common site of oral cavity carcinoma? (A) lateral orders of the mobile tongue (B) floor of mouth (C) vermilion border of the lateral margins of the lower lip (D) hard palate
is the commonest tumor of the parotid gland (pleomorphic adenoma) (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 584
A 28 year old man presents with a 5 year history of a slow growing, painless, preauricular mass. FNAB showed clusters of bland cells admixed with myxoid material. He undergoes parotidectomy, and histopathologic examination of the mass shows bland epithelial cells forming clusters, ducts, and sheets, with surrounding myxoid stroma. SEE SLIDE 15.19. There are also islands of cartilage. His tumor (A) can metastasize (B) is a chondrosarcoma (C) is the commonest tumor of the parotid gland (D) does not undergo malignant transformation
Heterotopic salivary tissue in a lymph node (Warthin tumor) (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 585.
A 55 year old male smoker undergoes parotidectomy for a cystic mass. Histopathology shows cystic spaces lined by abranching, two-tiered layer of epithelial cells, with well developed lymphoid tissue right beneath the lining. SEE SLIDE 15.20. This tumor is thought to arise from (A) respiratory epithelium (B) heterotopic salivary tissue trapped within a lymph node (C) myoepithelial cells (D) macrophages
Smaller than normal, firm, with a nodular external surface (cirrhosis) (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 587
A 60 year old chronic alcoholic man suddenly has massive hematemesis and dies. At autopsy, his lower esophagus shows bluish, dilated veins in the submucosa with surrounding erythema. One of the veins is ruptured. Which of the following is expected of his liver? (A) smaller than normal, firm, with nodular external surface (B) markedly enlarged, with multiple hemorrhages on cut section (C) smaller than normal, with a nutmeg appearance on cut section (D) markedly enlarged, with a greasy yellowish cut surface
Reflux esophagitis(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 588
A 24 year old female complains of heartburn, usually following spicy or sour meals. She takes antacids, with partial relief. She undergoes endoscopy where her lower esophagus appears diffusely erythematous with some epithelial erosions. A biopsy showed eosinophils in the epithelial layer, with basal zone hyperplasia. This is (A) reflux esophagitis (B) Barrett esophagus (C) esophageal candidiasis (D) squamous cell carcinoma
Adenocarcinoma of the esophagus(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 581
A 33 year old man with a 10 year history of intermittent heartburn undergoes endoscopy, where his lower esophagus appears salmon-pink and velvety. Biopsy of the velvety area shows an epithelium composed of columnar cells with dark basal nuclei, and interspersed goblet cells. Compared to the normal population, this man has a 30- to 100-fold greater risk of developing (A) lymphoma (B) squamous cell carcinoma (C) adenocarcinoma (D) carcinoid
middle third (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 590
Which is the most common site of esophageal squamous cell carcinoma? (A) cervical (B) upper thoracic (C) middle third (D) distal third
Helicobacter pylori(TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 592
What is the most important etiologic association of chronic gastritis? (A) Helicobacter pylori (B) Smoking (C) Alcohol abuse (D) NSAIDS
adenocarcinoma and lymphoma (TOPNOTCH)Robbins Basic Pathology, 8th Ed p.592
The histologic changes in chronic gastritis may predispose to the development of (A) squamous cell carcinoma and adenocarcinoma (B) adenocarcinoma and lymphoma (C) lymphoma and gastrointestinal stromal tumour (D) gastroinstestinal stromal tumor and squamous cell carcinoma
necrosis, inflammation, granulation tissue, scar (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 596
A 34 year old triathlete on chronic NSAIDs consults for chronic epigastric pain. An endoscopy showed a punched out, 2cm diameter ulcer in the duodenum, with perpendicular margins, extending into the submucosa. If a biopsy is performed, arrange the following layers from internal to external: (A) inflammation (B) necrosis (C) scar (D) granulation tissue
multiple,
A 25 year old man who suffered from a scalding burn, 80% of his body surface area, is admitted. In the burn unit, coffee ground material is observed in his NGT. Which of the following describes the type of gastric ulcer expected? (A) multiple,
adenoma (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 597-598
Which of the following gastric polyps is a true neoplasm? (A) hyperplastic polyp (B) hypoplastic polyp (C) fundic gland polyp (D) adenoma
E cadherin mutation (all other choices are risk factors for intestinal type) (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 598
Which of the following is a known risk factor for the diffuse type of gastric adenocarcinoma? (A) intestinal metaplasia (B) dietary nitrites (C) E-cadherin mutation (D) Her2-neu amplification
the diverticulum may have functioning gastric mucosa (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 600
Why do infants and children with Meckel diverticulum often present with melena? (A) the mucosa of the diverticulum is highly vascular (B) the diverticulum may have functioning gastric mucosa (C) patients with Meckel diverticulum have an increased likelihood of developing adenomas that can bleed (D) Meckel diverticulum is susceptible to Entamoeba histolytica infection
absence of ganglion cells in the sigmoid (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 601
A 3 month old female with a perinatal history of delayed passage of meconium presents with alternating diarrhea and constipation. Imaging studies show a dilated cecum, ascending and transverse colon. The remaining distal colon is not dilated. Which of the following biopsy findings confirms Hirschprung disease? (A) absence of ganglion cells in the sigmoid (B) presence of ganglion cells in the transverse colon (C) presence of ganglion cells in the cecum (D) presence of ganglion cells in the descending colon
hemorrhagic and necrotic mucosa and submucosa with sloughing off of epithelium (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 602
A 65 year old diabetic suffers an acute MI and is admitted at the ICU. The next day, he develops severe abdominal pain and melena, and dies a few hours later. Autopsy showed a dark red jejunum and ileum. Examination of one of the mesenteric artery branches shows 95% narrowing by atherosclerosis. Which of the following is the expected histologic finding of the affected bowel? (A) increased mitotic rate in mucosal crypts, decreased maturation of surface epithelial cells, variable neutrophilic infiltration (B) hemorrhagic and necrotic mucosa and submucosa with sloughing off of epithelium (C) tortuous mucosal and submucosal vessels (D) flask like submucosal ulcers filled with necrotic debris
size (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 618
Which of the following features of intestinal adenomas is the main determinant of risk of harboring an adenocarcinoma? (A) size (B) histologic architecture (C) severity of dysplasia (D) degreee of inflammation
44 year old female with 150-160 tubular adenomas in the colon (minimum of 100 colonic adenomas) (TOPNOTCH)Robbins Basic Pathology, 8th Ed p. 619
Which of the following is most likely affected by Familial Adenomatous Polyposis? (A) 44 year old female with 150-160 tubular adenomas in the colon (B) 65 year old male with 20-30 tubulovillous adenomas in the colon (C) 54 year old female with 120-130 hyperplastic polyps in the colon (D) 13 year old male with 30-40 hamartomatous polyps in the colon
Appendix (also, rectum) (TOPNOTCH)Robbins Basic Pathology, 8th Ed p.626
Carcinoids in which of the following location is least likely to have metastasized at the time of diagnosis? (A) appendix (B) ileum (C) stomach (D) colon
1) Flagella; 2) Urease (raises pH around bacterium); 3) Adhesins; 4) Toxins (involved in ulcer or cancer development) (TOPNOTCH)Robbins Basic Pathology, 9th Ed p.566
Four features liked to H. pylori virulence
Antrum (TOPNOTCH)Robbins Basic Pathology, 9th Ed p.567
Which part of the stomach do you biopsy for evaluation of H. pylori gastritis?
Decreased (TOPNOTCH)Robbins Basic Pathology, 9th Ed p.567
INCREASED or DECREASED: Gastrin in H. pylori infection
Increased (TOPNOTCH)Robbins Basic Pathology, 9th Ed p.567
INCREASED or DECREASED: Gastrin in autoimmune gastritis
Autoimmune gastritis (TOPNOTCH)Robbins Basic Pathology, 9th Ed p.567
Characterized by diffuse damage of oxyntic mucosa within BODY and FUNDUS. In contrast with H. pylori gastritis, the inflammatory reaction is DEEP and centered on gastric glands. There is parietal and chief cell loss.
Classic peptic ulcer(TOPNOTCH)Robbins Basic Pathology, 9th Ed p.568
Round to oval, sharply punched-out defect, with a smooth and clean base with rich granulation tissue.
Anti-parietal cell and anti-intrinsic factor antibodies. (TOPNOTCH)Robbins Basic Pathology, 9th Ed p.569
Antibodies typically present in autoimmune gastritis
H. pylori and EBV (TOPNOTCH)Robbins Basic Pathology, 9th Ed p.570
Two infectious agents linked to development of gastric cancer
Tyrosine kinase c-KIT (TOPNOTCH)Robbins Basic Pathology, 9th Ed p.572
Related mutation to GIST
Neural crest cells (TOPNOTCH)Robbins Basic Pathology, 9th Ed p.574
During embryogenesis, failure of ______ to migrate from cecum to recum causes Hirchsprung disease.
Tyrosine kinase RET loss of function mutation (TOPNOTCH)Robbins Basic Pathology, 9th Ed p.574
Mutation associated with Hirschsprung disease
Acute intestinal ischemia (TOPNOTCH)Robbins Basic Pathology, 9th Ed p.575
Can present as atrophy or sloughing of surface epithelium with hyperproliferative crypts. Inflammation initially absent, but neutrophils can be recruited within hours of reperfusion. Bacterial superinfection of the lesion may also lead to pseudomembrane formation that resembles C.diff colitis.
Secretory (TOPNOTCH)Robbins Basic Pathology, 9th Ed p.582
OSMOTIC or SECRETORY diarrhea: Cholera
CROHN (TOPNOTCH)Robbins Basic Pathology, 9th Ed p.587
CROHN DISEASE or ULCERATIVE COLITIS: Skip lesion and can occur anywhere in the GI tract
Ulcerative Colitis (TOPNOTCH)Robbins Basic Pathology, 9th Ed p.587
CROHN DISEASE or ULCERATIVE COLITIS: Thin bowel wall appearance with broad-based ulcers, with normal parts looking like pseudopolyps. At risk to develop toxic megacolon.
CROHN (TOPNOTCH)Robbins Basic Pathology, 9th Ed p.587
CROHN DISEASE or ULCERATIVE COLITIS: At risk to develop fistulas, malabsorption, and recurrence after surgery
CROHN (TOPNOTCH)Robbins Basic Pathology, 9th Ed p.587
CROHN DISEASE or ULCERATIVE COLITIS: Transmural inflammation with deep, knife-like ulcers with crypt abscesses. Leads to cobblestone appearance.
CROHN (TOPNOTCH)Robbins Basic Pathology, 9th Ed p.587
CROHN DISEASE or ULCERATIVE COLITIS: Presence of NONCASEATING GRANULOMAS in 35%
Both, especially if with colonic involvement in CROHN (TOPNOTCH)Robbins Basic Pathology, 9th Ed p.587
CROHN DISEASE or ULCERATIVE COLITIS: Risk for colon cancer
Terminal ileum, ileocecal valve, cecal area (TOPNOTCH)Robbins Basic Pathology, 9th Ed p.589
Common site of involvement in Crohn disease
CROHN (TOPNOTCH)Robbins Basic Pathology, 9th Ed p.590
CROHN DISEASE or ULCERATIVE COLITIS: Metaplastic changes, such as psudopyloric metaplasia (gastric antral-appearing glands) and Paneth cell metaplasia (in the left colon where Paneth cells are normally absent)
Ulcerative Colitis (TOPNOTCH)Robbins Basic Pathology, 9th Ed p.587
CROHN DISEASE or ULCERATIVE COLITIS: Typically just involves the colon but can involve the distal ileum (backwash ileitis)
Tuberous sclerosis (TOPNOTCH)Robbins Basic Pathology, 9th Ed p.593
SYNDROME: Hamaromatous polyp + Facial angifibroma + renal angiomyolipoma + cortical tubers
Cronkhite-Canada Syndrome (TOPNOTCH)Robbins Basic Pathology, 9th Ed p.593
SYNDROME: Hamaromatous polyp + Nail atrophy + Hair loss + Cachexia + Anemia + Abnormal skin pigmentation
Both serrated, but hyperplastic polyps occur more on the left colon. Sessile serrated often on the right. Also, sessile serrated is fully serrated including the crypt base, with crypt dilation and lateral growth. (TOPNOTCH)Robbins Basic Pathology, 9th Ed p.594
How does one differentiate a hyperplastic polyp (no malignant potential) to a sessile serrated adenoma?
APC tumor suppressor gene inactivation (TOPNOTCH)Robbins Basic Pathology, 9th Ed p.597
Initial mutation in the classic adenoma-carcinoma sequence which acounts for 80% of sporadic colon tumors
Polypod, exophytic (TOPNOTCH)Robbins Basic Pathology, 9th Ed p.597
Typical appearance of proximal colon adenocarcinoma
Annular that produce napkin ring constrictions and cause obstruction (TOPNOTCH)Robbins Basic Pathology, 9th Ed p.597
Typical appearance of distal colon adenocarcinoma
