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Flashcards in esophageal pathology Deck (26):
1

features of esophagitis

inflammation and injury of esophageal mucosa. Inury may lead to inflammation, or inflammation may lead to injury.

2

esophagitis histology

reactive epithelial changes with eosinophils or neutrophils

3

etiologies of esophagitis

Chemical injury: reflux, acids, alcohol, tobacco, meds. Infection: fungal or viral. Immune related: eosinophilic esophagitis. Radiation. Trauma.

4

Most prevalent form of esophagitis

reflux esophagitis

5

reflux esophagitis features

injury and inflammation that results from reflux of gastric contents into the esophagus. Results in GERD: heartburn, dysphagia, regurgitation

6

Pathophys of GERD

Hiatal hernia, decreased LES tone, increased abdominal pressure and delayed gastric emptying

7

GERD progression

erythema > erosion > ulceration. Few eosinophils at beginning.

8

Compare herpetic vs candida esophagitis

herpetic: pushed out ulcers and viral inclusions on histology. Candida: white plaques, and fungus on histology

9

What is eosinophilic esophagitis

caused by allergic and immunologic factors. Frequently coexists with allergic dz. Causes dysphagia, food impaction, and symptoms overlapping with GERD

10

Eosinophilic esophagitis scope and histology findings

scope: linear furrows and ringed esophagus. Histology: many eosinophils

11

List the various causes of esophageal obstruction

Functional: Nutcracker esophagus, Diffuse esophageal spasm, Hypertensive lower esophageal sphincter, Achalasia. Structural: Benign esophageal stenosis, Esophageal mucosal webs, Schatzki rings, Tumors

12

describe esophageal web

Web of tissue that partially obstructs esophagus

13

describe diffuse esophageal spasm

appears as a corkscrew esophagus

14

what is achalasia

area of constriction with megaesophagus above

15

common congenital anomalies of esophagus

atresia and fistulae

16

What are Mallory-Weiss tears

tears in esophagus from severe retching or vomiting, often associated with alcohol intoxication

17

What is Barrett esophagus

complication of chronic GERD. characterized by intestinal glandular metaplasia and confers increased risk of esophageal cancer

18

Histology of Barretts esophagus

epithelium is intestine like- columnar and glandular (metaplasia)

19

Progression of GERD

GERD > metaplasia (barretts) > dysplasia > adenocarcinoma

20

Histology of dysplasia in Barretts esophagus

low grade: elongated, dark nuclei. High grade: rounded nuclei, crowded glands

21

Most common types of esophageal tumors

adenocarcinomas and squamous cell carcinomas

22

Risk factors for adenocarcinoma

Most commonly arises from Barrett esophagus. associated with GERD, tobacco use, and radiation exposure. More common in men 7:1.

23

Adenocarcinoma histology

infiltrative, malignant glands

24

adenocarcinoma symptoms

dysphagia, odynophagia, weight loss, hematemesis

25

Squamous cell carcinoma risk factors

More common in Asia/africa. More common in men (4:1). Associated with alcohol, tobacco, dietary factors.

26

Squamous cell carcinoma symptoms

dysphagia, odynophagia, weight loss, hematemesis