Histology of esophageal disorders

Question 1

what percent of total epithelial thickness should the basal layer occupy?

Answer 1

less than 15%

Question 2

endoscopic and histologic findings in reflux esophagitis

Answer 2

hyperemia, patches resembling leukoplakia; basal hyperplasia, extension of papillae to the surface, PMN and Eo infiltration

Question 3

diagnosis of eosinophilic esophagitis. Etiology?

Answer 3

15 or more Eo in 2 or more high power fields or 25 in any HPF. Also microabcesses and dysphagia. Allergic in kids, unknown in adults

Question 4

path findings in Barrett’s. Pathogenesis?

Answer 4

squamous replaced by metaplastic intestinal columnar with goblet cells. GER leads to ulcer, ulcer is re-epithelialized by stem cells in abnormal milieu and become gastric or intestinal type

Question 5

complications of Barrett’s? classification?

Answer 5

adenocarcinoma. low grade dysplasia retains crypts and general structures, high grade dysplasia does not

Question 6

name benign and malignant epithelial neoplasms

Answer 6

Benign: squamous papilloma. Malignant: sq. cell carcinoma, adenocarcinoma, small cell ca.

Question 7

squamous cell carcinoma incidence by geography and sex

Answer 7

highest esophageal cancer throughout world, in US is adenocarcinoma. Men more common in lower third, women in upper third (with plummer-vinson)