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8/13/2019 Oral and Esophageal Pathology
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Faculty of Allied Medical Sciences
Histopathology and Cytology
MLHC-201
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THE PATHOLOGY OF THEGASTRO INTESTINALTRACT
Supervision
Prof.Dr.Noha Ragab
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outcomes
By the end of this lecture, the student willbe able to understand the pathology of
gastrointestinal tract and oral cavity
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THE PATHOLOGY OFTHE ORAL CAVITY
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Benign NeoplasmsPAPILLOMA:Squamous papilloma is a benign, exophytic
epithelial neoplasm composed ofbranching fronds of squamous epithelium
with fibrovascular cores.
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Squamous Cell CarcinomaSCC) 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.
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ULCERS OF THE ORAL CAVITY1. Dental ulcer:traumatic ulcer by a sharp tooth
2. Aphthous ulcer: very common Painful,recurrent, solitary or multiple, smallulcers. The lesion consists of a shallowulcer covered by a fibrinopurulentexudate and inflammatory infiltrate.
3. Tuberculous ulcer: an ulcer with underminededges and caseous floor. It most commonlydevelops at the tip of the tongue. Coughedsputum containing bacilli leads to infection of
the tongue4. Malignant ulcer:the ulcer edges are raised and
everted, the floor of ulcer is rough, necrotic andthe base of the ulcer is indurated.
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Salivary Glands
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NLARGEMENT: Unilateral enlargementof major salivary
glands is usually caused by cysts, stones,
inflammation, or neoplasms.
Bilateral enlargement is due to
inflammation (mumps, Sjgren syndrome),
granulomatous disease (Saroidosis), or
diffuse neoplastic involvement (leukemia or
malignant lymphoma).
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IALOLITHIASIS: Stonesoccur in salivary gland ducts,
mostly in the sub-mandibular gland. The
most important consequence of stoneformation is duct obstruction, often
followed by inflammation distal to the
occlusion.
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MUMPS Acute viral parotitis. Mainly
affecting children, rare in adults Eitiology:Mumps virus, transimitted by
droplet infection. Incubation
period: 2-4 weeks
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Benign Salivary GlandNeoplasms
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Pleomorphic AdenomaMixed Tumor)Pathology:
Pleomorphic adenoma is a slowlygrowing, painless, movable, firm
mass that has a smooth surface.
Microscopically: the tumors showepithelial tissue intermingled with
myxoid or chondroid areas,reflecting a mixtureof epithelial andmesenchymal components.
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Malignant SalivaryGland Tumors
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Mucoepidermoid Carcinoma: Mucoepidermoid carcinoma is a malignant salivary
gland tumor composed of a mixture of neoplasticepidermoid cells, mucus-secreting cells, andepithelial cells of an intermediate type.
Grossly:
Mucoepidermoid carcinoma grows slowly andpresents as a firm painless mass.
Microscopically:
Tumors form irregular solid, duct-like and cysticspaces, which include squamous cells, mucus-secreting cells, and intermediate cells.
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Adenoid Cystic Carcinoma: Adenoid cystic carcinoma is a
slowly growing salivary gland
malignancy with a tendency toinvade locally and recur after
surgical resection.
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Pathology: The tumor cells are small, have
scant cytoplasm, and grow in solidsheets or as small groups, strands,
or columns.
Within these structures, the tumorcells interconnect to enclose cystic
spaces, resulting in a solid, tubularor cribriform (sieve-like)
arrangement.
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ESOPHAGUS
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Congenital disorders: Tracheosophageal fistula: congenital
connection between the esophagus andtrachea
Esophageal webs:web-like protrusions ofthe esophageal mucosa into the lumen
Achalasia: failure of the loweresophageal spincter (LES) to relax withswallowing
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Esophageal varices: Diltated submucosal veins in the lower third
of the esophagus, usually secondry toportal
hypertension. Cause: liver cirrhosis
Clinically: massive hematemesis when
ruptured
Complication: potentially fatal hemorrhage
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Esophagitis
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Gasteroesophageal reflux diseasereflux esophagitis) Esophageal irritation and inflammation due to
reflux of gastric secretion into the esophagus.
Clinically: heart burn and regurgitation
Complications: Bleeding
Stricture Barrette esophagus
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ESOPHAGEAL CARCINOMA
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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
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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)
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Assignments
Causes of Epistaxis
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Thank You