which type of benign SALIVARY tumor has the following characteristics: 1. Most common neoplasm 2. Mesenchymal and epithelial component 3. may undergo malignant transformation

Pleomorphic adenoma (mixed tumor) - 60% occur in parotid - lobulated, firm on palpation

GI pathology Flashcards by asw asw

what is a sialadenitis?

Inflammatory lesion of the salivary gland

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what are the symptoms of sialadenitis?

Dry mouth and/or gland swelling with pain

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what causes a sialadenitis to develop?

1) Sarcoidosis
2) mumps
3) salivary duct stones with obstruction

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what causes Sjogren’s Disease? what group is the most at risk?

Autoimmune

most likely in 50-60 year old Females

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what are the clinical characteristics of Sjogren’s disease?

Dry mouth (xerostomia), dry eyes (kerato-conjunctivitis sicca)

BILATERAL swelling of parotid glands

Increased incidence of lymphoma

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which salivary gland is most frequently involved with salivary gland tumors?

Parotid gland

80% of all salivary tumors, most benign

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what is the most common MALIGNANT tumor of the salivary gland?

Mucoepidermoid carcinoma

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name the 2 types of benign salivary tumors

Pleomorphic adenoma (mixed tumor)

Warthin’s tumor (Papillary cystadenoma lymphomatosum)

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which type of benign SALIVARY tumor has the following characteristics:

Most common neoplasm
Mesenchymal and epithelial component
may undergo malignant transformation

Pleomorphic adenoma (mixed tumor)

60% occur in parotid
lobulated, firm on palpation

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what are the characteristics of warthin’s tumors?

Occurs virtually only in the parotid gland
mainly in MALES
10% bilateral, 10% multifocal
Oncocytes, lymphocytes
Benign

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what are the 2 types of malignant salivary gland tumors?

Mucoepidermoid carcinoma

2. Other carcinomas, which include Adenoid cystic and Acinic cell

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what are the characteristics of mucoepidermoid carcinomas?

Malignant
15% of all salivary gland tumors
Parotid gland + minor palate glands
may see BLUISH color

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For the esophagus, what causes functional obstructive diseases? what about obstruction diseases?

Functional: discoordinated contraction or spasm of the musculature
Obstruction-can be mechanical e.g. due to post-inflammatory stenosis

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what usually causes esophageal varices?

portal hypertension

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reflux of gastric juices is central to the associated mucosal injury of _______

GERD

gastroesophageal reflux disorder

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what are the symptoms of GERD?

dysphagia, heartburn, regurgitation gastric contents

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what is Odynophagia? what disease is it associated with?

pain on swallowing

associated with GERD

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what is Barrett Esophagus? what is it the result of?

intestinal metaplasia within the esophagus squamous mucosa

its a complication of GERD

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Barrett Esophagus is associated with an increased risk for _____________

Adenocarcinoma

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T/F: most people with Barrett esophagus develop esophageal tumors

FALSE

they do NOT develop esophageal tumors

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what are the 2 diagnostic features of Barrett esophagus

1) extension abnormal mucosa above gastro-esophageal junction
2) demonstration of squamous metaplasia (intestinal metaplasia)

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what is the “first pass effect”?

material absorbed from the GI tract are delivered to the liver via the portal vein before reaching inferior vena cava

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what groups are at a higher risk for esophageal adenocarcinoma? where does it develop?

increased in caucasians, increased in males over females (7:1)

Usually develops in the distal third of the esophagus

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what are the risk factors for squamous cell carcinoma of the esophagus?

EtOH
tobacco use
very hot beverages
caustic esophageal injury (acid reflux)

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SCC of the esophagus occurs primarily in the _________ third of the esophagus

middle third

_________ is the most common esophageal malignancy worldwide

SCC squamous cell carcinoma

what groups are at risk for esophageal Squamous Cell Carcinoma?

adults over 45 yo males > females (4:1)

name the characteristics of Acute gastritis:

- TRANSIENT, abrupt, variable pain - Asymptomatic to ulceration - Punctate hemorrhage, erosion, inflammation - causes: smoking, alcohol, stress, NSAIDs, asprin

chronic gastritis is almost always associated with an infection of _____________

Helicobacter pylori 65% gastric ulcers 85-100% duodenal ulcers

T/F: the progression of chronic gastritis is relatively rapid after exposure to H. pylori

False Often acquire the infection in childhood

what is the pathogenesis & clinical course for chronic gastritis:

Pathogenesis: - Autoimmune e.g. pernicious anemia - Infection, chemical Clinical course: - Ulceration - cancer risk 2-4% (intestinal metaplasia)

Approximately 75% of gastric polyps are ___________ or ______________

inflammatory or hyperplastic

what are the types of benign stomach neoplasias?

hyperplastic, fundic gland polyps, adenomas & inflammatory polyps

there is an increased risk for gastric adenomas in people suffering from _______________ (a genetic disease)

Familial adenosis polyposis (FAP)

where to gastric adenomas frequently arise from?

arise in a background of atrophy and intestinal metaplasia

90% of gastric cancers are _______________

adenocarcinomas

why has the rate of GI adenocarcinoma decreased in the united states?

due to reduced use of smoked and salt-cured meat

There is an association of gastric adenocarcinoma with ________ due to increased rates for cancer of gastric cardia

GERD

what is "Linitis plastica"?

“leather bottle appearance” markedly thickened stomach wall - very aggressive and deadly form of stomach cancer (a type of adenocarcinoma)

Linitis plastica is a diffuse type of ___________ adenocarcinoma

stomach

Risk factors for development of gastric adenocarcinomas:

- Hereditary factors - Additional factors e.g. consumption of smoked and salt cured meat, GERD - Pernicious anemia (B12deficiency), atrophic gastritis (intestinal metaplasia) - A pre-existing adenomatous polyp

T/F: a lymphoma neoplasia can develop in the stomach

true

what are the 2 other names for celiacs disease?

celiac sprue or gluten-sensitive enteropathy

Infectious enterocolitis, and celiac's disease, are examples of what type of GI disorder?

Small Intestine-reactive, non-neoplastic conditions

viral gastroenteritis and parasitic enterocolitis can both effect the ______________

small intestine

________________ arises from inappropriate mucosal immune activation

inflammatory bowel disease

what are 2 examples of inflammatory bowel disease?

Crohn Disease ulcerative colitis

what are the characteristics of ulcerative colitis?

- severe ulcerating inflammatory disease - limited to the colon and rectum - extends only to mucosa and submucosa

what are the characteristics of crohn's disease? | AKA regional enteritis

- may involve any area of the GI tract - is frequently transmural (extends over entire wall) - note noncaseating granulomas

T/F: both ulcerative colitis and crohn's disease are idiopathic

true | unknown cause

although ulcerative colitis is related to Crohn's, ______ is limited to the colon and always involves the rectum

ulcerative colitis

both Ulcerative colitis and Crohn's disease put the person at a higher risk for __________

neoplasia

tumors of the ____________ Accounts for less than 5% of all GI tumors

small intestine

what are the risk factors for colorectal cancers?

- AGE (over 50) - high fat, low fiber diet - family history of Colorectal cancer - Hereditary colon syndromes (FAP)

what are the possible types of BENIGN small intestine tumors?

leiomyoma Adenoma

what are the 3 types of malignant neoplasias of the small intestine

Adenocarcinomas carcinoid tumors lymphoma

name the characteristics of autoimmune (chronic) gastritis

loss of parietal cells ↓intrinsic factor ↓ B12 absorption pernicious anemia

what is the pathogenesis of acute gastritis?

Cigarettes, alcohol Stress, ischemia NSAID’s, aspirin, infection

where are 98% of peptic ulcers found?

duodenum* or stomach

what are the complications of peptic ulcers?

Bleeding- 15% to 20%, 1/4 deaths Perforation- 5%, 2/3 deaths (most common cause) Obstruction- edema, scarring- 2%

what are the histological signs of Celiac's disease? (gluten sensitivity)

Blunted villi Inflammatory infiltrate (dramatically improves when gliadin is removed)

a malaborption of what nutrients causes Osteopenia and tetany?

from defective Ca, Mg, Vit D and protein absorption

what is the effect of vitamins A and B12 Deficiencies?

peripheral neuropathy nyctalopia (night blindness from ↓Vit A)

what is the first ORAL manifestations of malabsorption?

- atrophic glossitis (bald, red tongue) | - glossopyrosis (burning tongue)

___________ (a Burning sensation of the tongue) is a common complaint during malabsorption

glossopyrosis

what diseases cause malabsorption in the small intestine?

1) Celiac disease 2) Tropical sprue (bacteria) 3) Whipples disease (lymphatics) 4) Disaccharidase deficiency 5) Abetalipoproteinemia (effects transport across epithelium)

what are the different types of colon polyps?

A) Hyperplastic- ↑ number cells B) Inflammatory C) Hamartomatous- ↑ in tissue normally found at this site) D) Adenomatous (neoplastic, tumor)

________ is the most important factor in predicting the malignancy of a adenoma colon polyp

size

______________ is the most common malignancy of the GI tract

Adenocarcinoma of the colon

when determining the STAGE of colon cancer, what do the letters "T N M" stand for?

T= depth of invasion N= lymph nodal involvement M= presence of metastasis

_______________ (a genetic disease) Entails mutations of APC gene, and is the MOST COMMON polyposis syndrome of the gastrointestinal tract

Familial Adenomatous Polyposis

Familial Adenomatous Polyposis, plus Extraintestinal lesions, is known as ___________ syndrome

Gardner’s syndrome

** name the oral manifestations for FAP

1) Unerupted teeth 2) supernumerary teeth 3) dentigerous and mandibular cysts 4) increased risk for odontomas

to be diagnosed with FAP, the patient must have how many tumors?

over 100

what are the characteristics of Peutz Jegher Syndrome?

- Gastrointestinal hamartomatous polyps | - pigmented macules of mucous membranes and skin

what are the oral manifestations of Peutz Jegher Syndrome?

Melanin deposits around nose, lips, buccal mucosa

In patients with Peutz Jegher syndrome, Gastrointestinal and non-gastrointestinal cancer are more common after _______ years old

what are the ORAL characteristics of Gardener's syndrome?

Jaw osteomas Supernumerary and/or unerupted teeth Increased risk for odontomas (can also have Desmoid tumors and CHRPE)

what disease is associated with "skip lesions" and can be found anywhere in the GI tract?

Crohn's disease

what type of Fissure/fistula forms in Crohn's disease?

Noncaseating granulomas

which ulcerative disease is RARELY found in the oral cavity?

Ulcerative colitis

what are the 2 types of malignant tumors of the ESOPHAGUS?

Adenocarcinoma (Barrett’s) Squamous cell carcinoma

SQUAMOUS CELL CANCER of the ESOPHAGUS is associated with what population groups?

M > F black > white

squamous cell cancer of the esophagus is usually found in the _____-third

middle

where do most Adenocarcinomas of the esophagus form?

distal 1/3rd

what are the 2 causes of esophageal adenocarcinoma?

Barrett's esophagus and/or long standing GERD

T/F: both SSCa and Adenocarcinomas of the esophagus have POOR 5 year survival

true

what type of neoplasm is responsible for 90-95% of all stomach tumors?

Adenocarcinomas

Gastric carcinoma is responsible for ____% of all cancer deaths

What types of cells are seen in Linitis Plastica?

Diffuse signet ring cells

what are the risk factors for Colorectal cancer?

1) High-fat, low-fiber diet 2) Age (>50 years) 3) Personal history of adenoma or Colorectal Carcinoma 4) hereditary colon cancer

Colon Adenocarcinoma is responsible for ____% all cancer deaths in USA

15%

what are the most important prognosis factors for colon adenocarcinoma?

1) depth of invasion | 2) lymph node metastases

where in the ORAL CAVITY do malignant neoplasms of the liver or GI tract usually metastasize to?

POSTERIOR mandible

what are the symptoms associated with a metastasis to the mandible?

Asymptomatic or jaw or tooth pain paresthesias or teeth loosening (unexplained)

what is the #1 oral SOFT tissue site for neoplasms?

attached gingiva #1 site, then tongue

T/F: oral metastasis of cancers is usually a grave sign

TRUE- usually signals widespread metastasis

T/F: oral metastasis of cancers is usually a grave sign

TRUE- usually signals widespread metastasis

what are the different categories for DEPTH ("T") of colon cancer?

1 Submucosa 2 Muscularis propria 3 Subserosa or non peritonealized pericolic fat 4 Contiguous structures

Intussusception (intestine obstruction due to folding) is characteristic of what condition?

Peutz-Jeghers Syndrome - caused by the Gastrointestinal hamartomatous polyps

GI pathology Flashcards

(100 cards)