Flashcards in Oral and Oesophageal Pathology Deck (23):
1
What are the main two inflammatory disorders of the oesophagus?
Acute Oesophagitis (rare) and Chronic oesophagitis (common)
2
What can cause acute oesophagitis?
Corrosive following chemical ingestion
Infective in immunocompromised patients e.g. candidiasis, herpes, CMV
3
What can cause chronic oesophagitis?
Reflux disease (reflux oesophagitis)
Rare causes include Crohn's disease
4
What causes reflux in pregnant women
Increased abdominal pressure
5
Define reflux oesophagitis
Inflammation of the oesophagus due to refluxed low pH gastric contents
6
Microscopically, what can be seen in the oesophagus of reflux oesophagitis?
Basal zone epithelial expansion
Intraepithelial neutrophils, lymphocytes and oesinophils
7
List some complications of reflux
Ulceration (bleeding)
Stricture
Barrett's oesophagus
8
What is Barrett's oesophagus
Replacement of stratified squamous epithelium by columnar epithelium
9
Describe the epidemiology of allergic oesophagitis
Eosinphillic oesophagitis
Personal or family history of allergy
Asthma
Young
Males > Females
10
What is the treatment for allergic oesophagitis
Steroids / chromoglycate / montelukast
11
What are the two different types of oesophageal tumours
Benign and Malignant
12
What is the most common type of benign tumour
Squamous papilloma
13
What are the 2 main types of malignant tumours and which one is most common?
Squamous cell carinoma
Adenocarcinoma (more common)
14
Describe the epidemiology of squamous cell carincoma
Commoner in males
Declining
Probably something to do with diet and culture
15
Describe the aetiology of squamous cell carcinoma
Vit. A, zinc deficiency
Tannic acid/ strong tea
Smoking, alcohol
HPV
Oesophagitis
Genetic
16
Describe the aetiology of adenocarcinoma of the oesophagus
Commoner in caucasians (white person with European origin)
Increasing in Europe and USA
Commoner in males and obesity
Commonest in the lower 1/3rd of the oesophagus
17
What is the pathway to Barrett's oesophagus
Inflammation, metaplasia, dysplasia, adenocarcinoma
18
Name the 3 mechanisms of metastases
Direct invasion
Lymphatic permeation
Vascular invasion
19
How would patients present with oesophageal carcinoma
Dysphagia
Anaemia
Weight loss
Loss of energy
20
What are the symptoms of oral squamous cell carcinoma
White, red, speckled, ulcer, lump
21
Where are the high risk sites
Floor of the mouth
Lateral border of tongue
Ventral tongue
Soft palate
Retromolar pad / tonsillar pillars
22
What is the aetiology of oral cancer
Tobacco
Alcohol
Betel quid
?Chronic infections
Nutritional deficiencies
? Genetics
History of primary oral squamous cell carcinoma have increased risk for 2nd primary
23