Transcript Pathology

Faculty of Allied Medical Sciences
Histopathology and Cytology
MLHC-201
THE PATHOLOGY OF THE
GASTRO INTESTINAL
TRACT
Supervision
Prof.Dr.Noha Ragab
outcomes
By the end of this lecture, the student will
be able to understand the pathology of
gastrointestinal tract and oral cavity
THE PATHOLOGY OF
THE ORAL CAVITY
Benign Neoplasms:
PAPILLOMA:
Squamous papilloma is a benign, exophytic
epithelial
neoplasm
composed
of
branching fronds of squamous epithelium
with fibrovascular cores.
Squamous Cell Carcinoma
(SCC)
• SCC is the most common malignant
tumor of the oral mucosa.
• Pathology:
SCC of the oral cavity is similar to the
same tumor in other sites.
ULCERS OF THE ORAL CAVITY
1.
2.
3.
4.
Dental ulcer: traumatic ulcer by a sharp tooth
Aphthous ulcer: very common Painful,
recurrent, solitary or multiple, small
ulcers. The lesion consists of a shallow
ulcer covered by a fibrinopurulent
exudate and inflammatory infiltrate.
Tuberculous ulcer: an ulcer with undermined
edges and caseous floor. It most commonly
develops at the tip of the tongue. Coughed
sputum containing bacilli leads to infection of
the tongue
Malignant ulcer: the ulcer edges are raised and
everted, the floor of ulcer is rough, necrotic and
the base of the ulcer is indurated.
Salivary Glands
ENLARGEMENT:
• Unilateral enlargement of major salivary
glands is usually caused by cysts, stones,
inflammation, or neoplasms.
• Bilateral enlargement is due to
inflammation (mumps, Sjögren syndrome),
granulomatous disease (Saroidosis), or
diffuse neoplastic involvement (leukemia or
malignant lymphoma).
SIALOLITHIASIS:
• Stones occur in salivary gland ducts,
mostly in the sub-mandibular gland. The
most important consequence of stone
formation is duct obstruction, often
followed by inflammation distal to the
occlusion.
MUMPS
• Acute viral parotitis. Mainly
affecting children, rare in adults
• Eitiology:
Mumps virus, transimitted by
droplet infection. Incubation
period: 2-4 weeks
Benign Salivary Gland
Neoplasms
A- Pleomorphic Adenoma
(Mixed Tumor)
Pathology:
• Pleomorphic adenoma is a slowly
growing, painless, movable, firm
mass that has a smooth surface.
• Microscopically: the tumors show
epithelial tissue intermingled with
myxoid
or
chondroid
areas,
reflecting a mixture of epithelial and
mesenchymal components.
Malignant Salivary
Gland Tumors
Mucoepidermoid Carcinoma:
• Mucoepidermoid carcinoma is a malignant salivary
gland tumor composed of a mixture of neoplastic
epidermoid cells, mucus-secreting cells, and
epithelial cells of an intermediate type.
Grossly:
• Mucoepidermoid carcinoma grows
presents as a firm painless mass.
slowly
and
Microscopically:
• Tumors form irregular solid, duct-like and cystic
spaces, which include squamous cells, mucussecreting cells, and intermediate cells.
Adenoid Cystic Carcinoma:
• Adenoid cystic carcinoma is a
slowly growing salivary gland
malignancy with a tendency to
invade locally and recur after
surgical resection.
Pathology:
• The tumor cells are small, have
scant cytoplasm, and grow in solid
sheets or as small groups, strands,
or columns.
• Within these structures, the tumor
cells interconnect to enclose cystic
spaces, resulting in a solid, tubular
or
cribriform
(sieve-like)
arrangement.
ESOPHAGUS
Congenital disorders:
•
Tracheosophageal
fistula:
congenital
connection between the esophagus and
trachea
•
Esophageal webs: web-like protrusions of
the esophageal mucosa into the lumen
•
Achalasia:
failure
of
the
lower
esophageal spincter (LES) to relax with
swallowing
Esophageal varices:
•
•
•
•
Diltated submucosal veins in the lower third
of the esophagus, usually secondry to portal
hypertension.
Cause: liver cirrhosis
Clinically: massive hematemesis when
ruptured
Complication: potentially fatal hemorrhage
Esophagitis
Gasteroesophageal reflux disease
(reflux esophagitis)
• Esophageal irritation and inflammation due to
reflux of gastric secretion into the esophagus.
• Clinically: heart burn and regurgitation
• Complications:
• Bleeding
• Stricture
• Barrette esophagus
ESOPHAGEAL
CARCINOMA
Squamous cell carcinoma (SCC)
of esophagus
• SCC is the most common type of esophageal
cancer
Risk factors:
• Heavy smoking
• Alcohols
• Achalasia
Clinical presentation:
•
•
•
•
At the beginning it may be asymptomatic
Then progressive dysphagia
Weight loss & anorexia
Bleeding
Adenocarcinoma (AC) of esophagus:
• Arise in the distal part of the
esophagus
• Associated with Barrett esophagus
(Metaplasia
of
the squamous
esophageal mucosa to columnar
type because of chronic exposure
to gastric secretions)
Questions:
Complete:
1-Adenoid Cystic Carcinoma is………………
2- Clinical presentation of scc is………..
3- Bilateral enlargement is due to…………..
4- Adenoid cystic carcinoma is
………….with a tendency to………………….
‫‪Assignments‬‬
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‫•‬
‫•‬
‫•‬
‫•‬
‫•‬
‫•‬
‫‪Causes of Epistaxis‬‬
‫محمد فوزى خضر بشاره‬
‫محمود محمد رمضان على العربى‬
‫مروة أشرف محمد أحمد‬
‫مروة حسن صقر‬
‫مروة يونس رمضان‬
‫ميرنا ابراهيم على‬
‫نادية محمد سعد‬
Thank You