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?