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42 Cards in this Set
- Front
- Back
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What is the epithelial change at the gastroesophageal junction?
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Squamous --> Columnar
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There is ____ mucosa in esophagus and ______ mucosa in stomach
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squamous; columnar
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What change to mucosa happens in Barrett's esophagus?
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Replacement of normal esophageal squamous mucosa with stomach columnar mucosa
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T/F n patients with portal hypertension (usually micronodular cirrhosis from chronic alcoholism), the submucosal esophageal veins become dilated (form varices). These varices are prone to bleed.
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T
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esophageal squamous carcinoma: most likely to be associated with what conditions?
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Smoking and alcohol consumption
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esophageal adenocarcinoma: likely to be associated with what?
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Barrett's esophagus
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What is the duodenal bulb?
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First portion of duodenum
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How do parietal cells appear histologically?
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Very bright pink/eosinophilic
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Which two viruses commonly cause esophagitis?
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Herpes, CMV
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Which stain helps visualize candida in candida esophagitis?
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silver
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T/F There is correlation between the pathological appearance of the esophagus and symptom severity
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F
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Metaplasia of what cells is most associated with adenocarcinoma?
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goblet cells
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How does eosinophilic esophagitis response to PPIs?
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They don't.
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Symptoms of eosinophilic esophagitis?
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Children vomiting, abdominal pain with allergic history.
Adults: dysphagia. |
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T/F Benign esophageal tumors are more common than malignant.
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F
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T/F Small Tumors are usually asymptomatic
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T
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(Mesenchymal, epithelial) tumors usually benign; (Mesenchymal, epithelial) tumors usually malignant
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Mesenchymal, epithelial
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What is a leiomyoma?
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benign tumor composed of mature smooth muscle preferentially arising in rectum and esophagus.
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Most common benign esophageal tumor
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leiomyoma
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What will a leiomyoma look like histologically?
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Smooth, circumscribed margin, not invading or ulcerating
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Malignant neoplasm of glandular epithelium of esophagus
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adenocarcinoma
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How to tell whether you're in the fundus/body of stomach vs. the antrum/pylorus?
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Look at the superficial: deep compartment ratio.
In fundus/body there's mostly the deep compartment. In the antrum/pylorus, it's about 50/50. |
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Most pathology occurs in what part of stomach?
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lesser curvature
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What is the pathogenesis of gastritis?
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There is direct impairment of mucosal barrier function.
Then there's injury to the proliferative compartment. Then damage to mucosal epithelial cells. Ischemia of the mucosa. |
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Histologic features of chronic gastritis?
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lymphocytes and plasma cells in the mucosa
inflammation "active" or "quiescent" depending on presence of neutrophils Progressive destruction of epithelium (chronic atrophic gastritis). Atrophy associated with intestinal metaplsia (replacement with intestinal type epithelium) |
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Achlorhydria may cause ______
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hypergastrinemia
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20% of chronic gastritis is what?
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autoimmune
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Mechanisms of cell injury of H pylori
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Attaches to epithelium
Recruits and activates inflammatory cells (with urease) Has LPS endotoxin tissue damage via ammonia Protease and lipase - impedes mucosal barrier |
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Complications of H pylori infection
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peptic ulcer disease
Adenocarcinoma Lymphoma |
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What is hypertrophic gastropathy?
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Giant hypertrophic gastritis (GHG) is a general term for inflammation of the stomach due to the accumulation of inflammatory cells in the inner wall (mucosa) of the stomach resulting in abnormally large, coiled ridges or folds that resemble polyps in the inner wall of the stomach (hypertrophic gastric folds). GHG encompasses a collection of disorders
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What is Menetrier's disease?
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Disorder where the gastric folds are enlarged (hypertrophic gastropathy).
This leads to protein loss, parietal cell atrophy, and an increase in mucous cells. It results from profound hyperplasia of the surface mucous cells with accompanying glandular atrophy. |
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What are complications of Menetrier's disease?
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The altered gastric mucosa secretes massive amounts of mucus, resulting in low plasma protein levels. The tissue may be inflamed and may contain ulcers. The disease also causes glands in the stomach to waste away and causes the body to lose fluid containing the protein albumin
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What is Menetrier's disease associated with?
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H pylori infection, CMV infection
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Sx of Menetrier's
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Epigastric Pain — pain after the meal (postprandial), relieved by antacids, is very usual
weight loss, cachexia peripheral edema, ascites anemia symptoms secondary to blood loss |
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Two morphologic types of stomach cancer
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Intestinal-type
Diffuse-type |
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What is the general pathogenesis of stomach cancer?
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Chronic gastritis --> Intestinal metaplasia --> Intestinal dysplasia -> Intestinal type carcinoma
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Adenocarcinoma of the stomach: tumors have a propensity fo involve what other organs (2)?
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Supraclavicular node (Virchow's node)
Ovaries bilaterally: Krukenberg tumor |
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What is Krukenberg tumor?
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Adenocarcinoma that involves the ovaries bilaterally
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What is Virchow's node?
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A metastatic supraclavicular node
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What is a gastrointestinal stromal tumor (GIST)?
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Tumor of connective (mesenchymal) tissue in GI tract. 70% in stomach.
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What is the gene mutation associated with GIST?
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tyrosine kinase c-kit
8-10% have mutation in PDGFα Most useful marker is immunohistochemistry for c-kit |
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What is the signet ring pattern in adenocarcinoma?
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cells are filled with mucin vacuoles that push the nucleus to one side, giving appearance of a signet ring.
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