Difference between revisions of "An introduction to gastrointestinal pathology"
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===Colon=== | ===Colon=== | ||
{{main|Colon}} | {{main|Colon}} | ||
Colorectal tumours are dealt with in ''[[colorectal tumours]]''. Crohn's disease and ulcerative colitis are dealt with in the ''[[inflammatory bowel disease]]'' article. | |||
Includes discussion of the [[rectum]]. The [[anus]] is a separate article. | |||
===Appendix=== | ===Appendix=== | ||
Revision as of 07:12, 3 December 2010
Gastrointestinal pathology is a large part of pathology as radiologists can often describe the extent of disease... but don't get the diagnosis right all the time.
Normal
Layers
Layers of the alimentary canal:[1][2]
- Mucosa (epithelium, lamina propria, muscularis mucosa).
- Submuscosa and submucosal plexus (or Meissner's plexus).
- Muscularis externa (inner longitudinal, myenteric plexus (or Auerbach's plexus) outer circumferential).
- Adventitia (if retroperitoneal), serosa (if intraperitoneal).
Cell types
- Goblet cells.
- Secrete mucin.
- Enterochromaffin cells, AKA Kulchitsky cells.
- Subnuclear eosinophilic granules.
- Serotonin.
- Subnuclear eosinophilic granules.
- Paneth cells.
- Supranuclear eosinophilic granules.
Memory device:
- Supranuclear granules = paneth cell.
Bowel
Small bowel
- Villi - should see three good ones in a normal biopsy.
- Crypts.
- Paneth cells.
- Goblet cells.
- Few in proximal small bowel (duodenum).
- Abundant in distal small bowel (ileum).
Duodenum
- Small bowel (as above).
- Submucosal glands (Brunner's glands).
Large bowel vs. small bowel
- Small intestine.
- Villi (key feature).
- Brunner's glands - duodenum only (key feature).
- Paneth cells more common.
- Paneth cells are in the base of the crypts and have eosinophilic granules. They are found (normally) in the small bowel and right colon. They may appear on the left side (i.e. descending colon) in pathologic states, e.g. IBD.
- Large intestine
- More goblet cells.
- More lymphocytes usually.
Luminal gastroenterology
Intestinal polyps
The bread and butter of gastrointestinal pathology.
Esophagus
Largely forgotten organ at SB... but no shortage of these at SMH.
Stomach
H. pylori, cancer and more...
Small bowel
The part of the GI tract that pathology has mostly forgot. Crohn's disease is dealt with in a separate article.
Duodenum
Commonly biopsied. Celiac... cancer... giardia?
Colon
Colorectal tumours are dealt with in colorectal tumours. Crohn's disease and ulcerative colitis are dealt with in the inflammatory bowel disease article. Includes discussion of the rectum. The anus is a separate article.
Appendix
Acute appendicitis and more...
Accessory GI
Gallbladder
A growth industry... with the expanding waist lines in the (Western) world.
Liver
An organ that pathologists now sometimes forget. There are separate articles for the medical liver diseases and liver neoplasms.
Pancreas
An organ that is occasionally afflicted by cancer. It is primarily seen in large centers where they do ERCPs and Whipples.
