Rosai Chapter 13 - Esophagus Flashcards
(96 cards)
1
Q
Esophagus approximately measures:
A
25 cm
2
Q
Margin of upper esophageal sphincter
A
Cricopharyngeal muscle
3
Q
Vertebral counterpart of the upper esophageal sphincter
A
C6
4
Q
Measurement of upper esophageal sphincter from the incisors
A
15-18 cm
5
Q
Margin of lower esophageal sphincter
A
Gastroesophageal junction (GEJ)
6
Q
Measurement of lower esophageal sphincter from the incisors
A
40 cm
7
Q
The point at which the tubular esophagus flares to the saccular stomach
A
GEJ
8
Q
GEJ is recognized endoscopically by the:
A
proximal margin of the gastric folds
9
Q
This is the irregular meeting point of the squamous and glandular epithelia
A
Squamocolumnar junction (SCJ)
10
Q
SCJ is also known as:
A
“Z line”
11
Q
SCJ or Z line will be found:
A
proximally displaced above the GEJ
12
Q
Most common tracheoesophageal anomaly
A
Type C
13
Q
This type of tracheoesophageal anomaly is characterized by esophageal atresia with a fistula between the lower portion of the esophagus and the respiratory tree
A
Type C
14
Q
Most common location of heterotopic gastric mucosa
A
postcricoid region
15
Q
other name of Heterotopic pancreatic tissue
A
Pancreatic acinar metaplasia
16
Q
Most common type of diverticulum in the upper aerodigestive tract
A
Zenker diverticula
17
Q
Zenker diverticula is located in the:
A
upper portion of the esophagus
18
Q
This esophageal cysts is lined by squamous or columnar epithelium sometimes ciliated
A
Inclusion cysts
19
Q
This esophageal cysts is arising from cystic dilation of submucosal glands
A
Retention cysts or Mucoceles
20
Q
This esophageal cysts can be of esophageal, bronchial, or gastric origin
A
Developmental cysts
21
Q
Component of Plummer-Vinson or Paterson-Kelly syndrome (3):
A
- Esophageal rings and Webs
- IDA
- increased incidence of carcinoma
22
Q
Esophageal rings and webs in Plummer-Vinson or Paterson-Kelly syndrome is characterized by (2):
A
- dysphagia
- found in upper esophagus of women
23
Q
Esophageal rings and webs located in the lower esophagus (3):
A
- Schatzki
- Esophagogastric
- Lower esophageal rings
24
Q
other name of Achalasia (2):
A
- Cardiospasm
- Megaesophagus
25
Characteristics of Allgrove (triple A) syndrome:
- Achalasia
- Adrenal deficiency or Addisonianism
- Alacrima
26
other name of Cricopharyngeal dysphagia (2):
- Cricopharyngeal achalasia
| - Cricopharyngeal spasm
27
Most common microscopic finding of Pseudoachalasia
Neoplastic infiltration of the myenteric plexus
28
other name of Giant muscular hypertrophy (3):
- Diffuse spasm
- Corkscrew esophagus
- Diffuse leiomyomatosis
29
Most common location of lye strictures of the esophagus:
Bifurcation of the trachea
30
Microscopic hallmarks of Herpes simplex esophagitis (3):
- inflammation
- ulceration
- Cowdry type A inclusions
31
Which of the microscopic hallmarks of herpes simplex esophagitis is not always identifiable?
-Cowdry type A inclusions
32
Eosinophilic (allergic) esophagitis vs.
Eosinophilic infiltration of mucosa in GERD:
-Eosinophilic microabscesses
Eosinophilic (allergic) esophagitis
33
Eosinophilic (allergic) esophagitis vs.
Eosinophilic infiltration of mucosa in GERD:
-Lamina propria fibrosis
Eosinophilic (allergic) esophagitis
34
other name of Esophagitis dissecans superficialis
Sloughing Esophagitis
35
Barrett esophagus segments:
LONG SEGMENT vs. SHORT SEGMENT
-Classic form
LONG SEGMENT
36
Barrett esophagus segments:
LONG SEGMENT vs. SHORT SEGMENT
-3 cm or more changes
LONG SEGMENT
37
Barrett esophagus segments:
LONG SEGMENT vs. SHORT SEGMENT
-less than 3 cm changes
SHORT SEGMENT
38
Intestinal type mucin:
MUC2
39
Gastric-type mucins (2):
- MUC5AC
| - MUC6
40
Diagnostic features of dysplasia easily recognizable at LPO (3):
- Cytoplasmic basophilia with loss of mucus
- Nuclear hyperchromasia
- Excessive nuclear stratification, often extending from the epithelial basement membrane to the luminal surface
41
Main features used to suggest an origin for an esophageal adenocarcinoma from Barrett mucosa (2):
- identification of goblet cells adjacent to the neoplasm
| - epicenter of the tumor being located on the esophageal side of the GEJ
42
Earliest molecular changes in Barrett esophagus (2):
- Loss of CDKN2A (by deletion or hypermethylation)
| - Loss of TP53 (by mutation and deletion)
43
Most common tumor of the GIT in the African Bantus
Esophageal Squamous Cell Carcinoma
44
Most common location of Esophageal SCCA:
-middle and lower thirds
45
Main differential diagnosis in a biopsy specimen of esophageal SCCA
-atypical regenerative hyperplasia
46
IHCs:
POSITIVE or NEGATIVE
-HMWK (CK5/6) in SCCA
Positive
47
IHCs:
POSITIVE or NEGATIVE
-p63 in SCCA
Positive
48
IHCs:
POSITIVE or NEGATIVE
-HMWK (CK5/6) in Adenocarcinoma
Negative
49
IHCs:
POSITIVE or NEGATIVE
-p63 in Adenocarcinoma
Negative
50
Term used for the carcinomas that do not invade beyond the muscularis mucosae
Intramucosal carcinoma
51
Term used for carcinomas that do not invade beyond the submucosa
Superficial (or microinvasive) carcinoma
52
Term used for those tumors having a lateral intramucosal spread of at least 2 cm beyond the invasive lesion
Superficial(ly) spreading carcinoma
53
other name of Sarcomatoid carcinoma (3):
- Carcinosarcoma
- Spindle cell carcinoma
- Polypoid carcinoma
54
Most common benign tumors of the esophagus
Leiomyomas
55
Main microscopic criteria by which leiomyosarcomas are separated from their more benign counterpart (3):
- Cytologic atypia
- Mitotic figures
- Necrosis
56
Usual predilection of Malignant Melanoma in the esophagus
-Lower third
57
Lining of the mucosa of the esophagus
Stratified squamous nonkeratinized
58
Mucous glands, in the lamina propria of the the distal portion of the esophagus, is also referred to as:
(Esophageal) Cardiac glands
59
Lymph node drainage of the esophagus:
Upper third
Cervical nodes
60
Lymph node drainage of the esophagus:
Middle third (2)
- Paraesophageal nodes
| - Paratracheal mediastinal nodes
61
Lymph node drainage of the esophagus:
Lower third
Nodes around the aorta and celiac axis
62
Heterotopic gastric mucosa is also referred to as:
(Cervical) inlet patch
63
This is due to a failure of relaxation of the lower esophageal sphincter while peristaltic waves conveying foood through the esophagus reach it
Achalasia
64
a well-recognized entity with prominent clinical symptoms but only meager microscopic findings, represented by degeneration and regeneration of the fibers of the cricopharyngeal muscle, accompanied by interstitial fibrosis
Cricopharyngeal dysphagia
65
A motor disorder of the esophagus characterized clinically by dysphagia and pathologically by focal or diffuse hypertrophy of the muscular layer
Giant muscular hypertrophy
66
This esophagitis should be suspected in the presence of "Volcano ulcers" at endoscopy and discrete, diffusely scattered, shallow ulcers on double-contrast esophagogram
Herpes simplex esophagitis
67
Microscopically, the diagnosis of this esophagitis should be made when finding the typical large cells with basophilic cytoplasm and large oval, eosinophilic intranuclear inclusions, usually at the base of the ulcer
Cytomegalovirus (CMV) esophagitis
68
This esophagitis is an endoscopically defined disease characterized by detachment of large fragments of squamous esophageal mucosa
Esophagitis dissecans superficialis
69
This esophagitis is characterized by intraepithelial and lamina propria lymphocytosis and apoptosis of squamous cells (so-called Civatte bodies) but showing an association with viral hepatitis and HIV infection
Esophagitis resembling lichen planus (Lichenoid Esophagitis)
70
defined as carcinoma that has penetrated through the basement membrane of the glands into the lamina propria or muscularis mucosae, but not below
Intramucosal carcinoma
71
Definitions of AJCC TNM for squamous cell carcinoma and adenocarcinoma
T category:
Tumor cannot be assessed
Tx
72
Definitions of AJCC TNM for squamous cell carcinoma and adenocarcinoma
T category:
No evidence of primary tumor
T0
73
Definitions of AJCC TNM for squamous cell carcinoma and adenocarcinoma
T category:
High-grade dysplasia, defined as malignant cells confined to the epithelium by the basement membrane
Tis
74
Definitions of AJCC TNM for squamous cell carcinoma and adenocarcinoma
T category:
Tumor invades the lamina propria or muscularis mucosae
T1a
75
Definitions of AJCC TNM for squamous cell carcinoma and adenocarcinoma
T category:
Tumor invades the submucosa
T1b
76
Definitions of AJCC TNM for squamous cell carcinoma and adenocarcinoma
T category:
Tumor invades the muscularis propria
T2
77
Definitions of AJCC TNM for squamous cell carcinoma and adenocarcinoma
T category:
Tumor invades adventitia
T3
78
Definitions of AJCC TNM for squamous cell carcinoma and adenocarcinoma
T category:
Tumor invades the pleura, pericardium, azygos vein, diaphragm, or peritoneum
T4a
79
Definitions of AJCC TNM for squamous cell carcinoma and adenocarcinoma
T category:
Tumor invades other adjacent structures, such as the aorta, vertebral body, or airway
T4b
80
Definitions of AJCC TNM for squamous cell carcinoma and adenocarcinoma
N category:
Regional lymph nodes cannot be assessed
Nx
81
Definitions of AJCC TNM for squamous cell carcinoma and adenocarcinoma
N category:
No regional lymph node metastasis
N0
82
Definitions of AJCC TNM for squamous cell carcinoma and adenocarcinoma
N category:
Metastasis in one or two regional lymph nodes
N1
83
Definitions of AJCC TNM for squamous cell carcinoma and adenocarcinoma
N category:
Metastasis in three to six regional lymph nodes
N2
84
Definitions of AJCC TNM for squamous cell carcinoma and adenocarcinoma
N category:
Metastasis in seven or more regional lymph nodes
N3
85
Definitions of AJCC TNM for squamous cell carcinoma and adenocarcinoma
M category:
No distant metastasis
M0
86
Definitions of AJCC TNM for squamous cell carcinoma and adenocarcinoma
M category:
Distant metastasis
M1
87
Definitions of AJCC TNM for squamous cell carcinoma and adenocarcinoma
```
Histologic grage (G) category:
Grade cannot be assessed
```
Gx
88
Definitions of AJCC TNM for squamous cell carcinoma and adenocarcinoma
```
Histologic grage (G) category:
Well differentiated
```
G1
89
Definitions of AJCC TNM for squamous cell carcinoma and adenocarcinoma
```
Histologic grage (G) category:
Moderately differentiated
```
G2
90
Definitions of AJCC TNM for squamous cell carcinoma and adenocarcinoma
```
Histologic grage (G) category:
Poorly differentiated, undifferentiated
```
G3
91
This category plays a role in stage grouping of esophageal squamous cancers and is defined by the position of the epicenter of the tumor in the esophagus
Location
92
Definitions of AJCC TNM for squamous cell carcinoma and adenocarcinoma
Location (L) category:
Location unknown
X
93
Definitions of AJCC TNM for squamous cell carcinoma and adenocarcinoma
Location (L) category:
Cervical esophagus to lower border of azygos vein
Upper
94
Definitions of AJCC TNM for squamous cell carcinoma and adenocarcinoma
Location (L) category:
Lower border of azygos vein to lower border of inferior pulmonary vein
Middle
95
Definitions of AJCC TNM for squamous cell carcinoma and adenocarcinoma
Location (L) category:
Lower border of inferior pulmonary vein to stomach, including gastroesophageal junction
Lower
96
Preferred term for a variant of squamous cell carcinoma with prominent peripheral palisading
Basaloid squamous cell carcinoma
