USMLE Gastrointestinal - Pathology
What is sialolithiasis?
Salivary gland stone which is a calcification within the gland or duct
Recurrent pre/periprandial pain + swelling. Caused by dehydration/trauma
Treatment: NSAIDs, gland massage, sour candies, warm compresses
Where do salivary gland tumours occur most commonly?
Parotid gland! - most commonly benign
What is the typical presentation of a salivary gland tumour?
Painless mass/swelling
Facial pain or paralysis may suggest malignant involvement on CN VII.
What is the most common salivary gland tumour?
Pleomorphic adenoma
Composed of:
- chondromyxoid stroma
- epithelium
RECURS IF INCOMPLETE EXCISION
What is the most common malignant tumour of the salivary gland?
Mucoepidermoid carcinoma
What is warthin tumour?
Benign cystic tumour of the salivary gland
Typically found in smokers
What is achalasia?
,Motor disorder of the esophagus characterized by impaired relaxation of the
lower esophageal sphincter (LES) and loss of peristalsis in the distal 2/3 of the
esophagus
Barium swallow shows dilated esopahgus with an area of distal stenosis
Increased risk of osophageal cancer.
What are the causes of secondary achalasia?
Chagas disease (t. cruzi infection)
other malignancies
What is Boerhaave syndrome?
Transmural esophageal rupture due to violent retching (Boerhaave =
been-heaving)
Pneumomediastinum (see picture) seen.
What is eosinophilic esophagitis?
Dense eosinophilic infiltration of submucosa that leads to structural
abnormalities over time
Typically unresponsive to GERD therapy
What is esophageal varices?
Dilated veins in the lower 1/3rd esophagus.
May be secondary to portal hypertension.
What is esophagitis?
Assoc. with reflux
Infection in immunocompromised (Candida, = white pseudomembrane. HSV-1
= punched out ulcers. CMV = linear ulcers).
May be caused by NSAIDs, tetracycline
, What is GORD?
Gastro-oesophageal reflux disorder
Heartburn, regurg, dysphagia.
also may present w/ chronic cough + horseness of voice.
assoc. w/ asthmatics
What is Mallory-Weiss syndrome?
Post-emesis/-retching tears in the gastric mucosa (near gastroesophageal
junction)
Often presents w/ hematemasis
Anorexics/bullemics
What is Plummer-Vinson syndrome?
Triad:
- Esophageal web (Dysphagia)
- Iron-deficiency anemia
- Glossitis
+/- Koilonychia (Spoon-shaped nails)
Associated with...
- Elderly women
- Increased risk for squamous cell cancer
What is Barrett's esophagus?
Specialized intestinal metaplasia
replacement of NON KERATENIZED STRATIFIED SQUAMOUS EPITHELIUM
WITH INTESTINAL EPITHELIUM IN DISTAL OESOPHAGUS.
due to chronic GORD.
Associated with increased risk of
adenocarcinoma
What is sialolithiasis?
Salivary gland stone which is a calcification within the gland or duct
Recurrent pre/periprandial pain + swelling. Caused by dehydration/trauma
Treatment: NSAIDs, gland massage, sour candies, warm compresses
Where do salivary gland tumours occur most commonly?
Parotid gland! - most commonly benign
What is the typical presentation of a salivary gland tumour?
Painless mass/swelling
Facial pain or paralysis may suggest malignant involvement on CN VII.
What is the most common salivary gland tumour?
Pleomorphic adenoma
Composed of:
- chondromyxoid stroma
- epithelium
RECURS IF INCOMPLETE EXCISION
What is the most common malignant tumour of the salivary gland?
Mucoepidermoid carcinoma
What is warthin tumour?
Benign cystic tumour of the salivary gland
Typically found in smokers
What is achalasia?
,Motor disorder of the esophagus characterized by impaired relaxation of the
lower esophageal sphincter (LES) and loss of peristalsis in the distal 2/3 of the
esophagus
Barium swallow shows dilated esopahgus with an area of distal stenosis
Increased risk of osophageal cancer.
What are the causes of secondary achalasia?
Chagas disease (t. cruzi infection)
other malignancies
What is Boerhaave syndrome?
Transmural esophageal rupture due to violent retching (Boerhaave =
been-heaving)
Pneumomediastinum (see picture) seen.
What is eosinophilic esophagitis?
Dense eosinophilic infiltration of submucosa that leads to structural
abnormalities over time
Typically unresponsive to GERD therapy
What is esophageal varices?
Dilated veins in the lower 1/3rd esophagus.
May be secondary to portal hypertension.
What is esophagitis?
Assoc. with reflux
Infection in immunocompromised (Candida, = white pseudomembrane. HSV-1
= punched out ulcers. CMV = linear ulcers).
May be caused by NSAIDs, tetracycline
, What is GORD?
Gastro-oesophageal reflux disorder
Heartburn, regurg, dysphagia.
also may present w/ chronic cough + horseness of voice.
assoc. w/ asthmatics
What is Mallory-Weiss syndrome?
Post-emesis/-retching tears in the gastric mucosa (near gastroesophageal
junction)
Often presents w/ hematemasis
Anorexics/bullemics
What is Plummer-Vinson syndrome?
Triad:
- Esophageal web (Dysphagia)
- Iron-deficiency anemia
- Glossitis
+/- Koilonychia (Spoon-shaped nails)
Associated with...
- Elderly women
- Increased risk for squamous cell cancer
What is Barrett's esophagus?
Specialized intestinal metaplasia
replacement of NON KERATENIZED STRATIFIED SQUAMOUS EPITHELIUM
WITH INTESTINAL EPITHELIUM IN DISTAL OESOPHAGUS.
due to chronic GORD.
Associated with increased risk of
adenocarcinoma
