48,830
edits
Difference between revisions of "Esophagus"
Jump to navigation
Jump to search
rearrange, wikify
(→Microscopy: rework) |
(rearrange, wikify) |
||
| Line 1: | Line 1: | ||
'''Esophagus''' connects the pharynx to the [[stomach]]. It is afflicted by tumours on occasion. For some reason or another, it seems everyone at SMH gets a esophageal biopsy... yet patients at SB don't have esophagi. | '''Esophagus''' connects the pharynx to the [[stomach]]. It is afflicted by tumours on occasion. For some reason or another, it seems everyone at SMH gets a esophageal biopsy... yet patients at SB don't have esophagi. | ||
=Normal= | |||
General: | General: | ||
*Stratified squamous non-keratinized epithelium. | *Stratified squamous non-keratinized epithelium. | ||
| Line 12: | Line 12: | ||
*Inflammatory cells should be very rare. | *Inflammatory cells should be very rare. | ||
=Diagnoses= | |||
Common | Common | ||
*Normal. | *Normal. | ||
| Line 25: | Line 25: | ||
*CMV esophagitis. | *CMV esophagitis. | ||
==Tabular summary== | |||
{| class="wikitable" | {| class="wikitable" | ||
|'''Entity''' | |'''Entity''' | ||
| Line 89: | Line 89: | ||
*Pyrosis = heartburn.<ref>URL: [http://dictionary.reference.com/browse/pyrosis http://dictionary.reference.com/browse/pyrosis]. Accessed on: 21 June 2010.</ref> | *Pyrosis = heartburn.<ref>URL: [http://dictionary.reference.com/browse/pyrosis http://dictionary.reference.com/browse/pyrosis]. Accessed on: 21 June 2010.</ref> | ||
=Infection= | |||
{{main|Microorganisms}} | {{main|Microorganisms}} | ||
Is a relatively common problem, especially in those that live at the margins (EtOH abusers) and immunosuppressed individuals ([[HIV|HIV/AIDS]]). | Is a relatively common problem, especially in those that live at the margins (EtOH abusers) and immunosuppressed individuals ([[HIV|HIV/AIDS]]). | ||
| Line 156: | Line 156: | ||
*[http://commons.wikimedia.org/wiki/File:Low-grade_sil_and_endocx.jpg LSIL & endocervix (WC)]. | *[http://commons.wikimedia.org/wiki/File:Low-grade_sil_and_endocx.jpg LSIL & endocervix (WC)]. | ||
== | =Other= | ||
==Gastroesophageal reflux disease== | ==Gastroesophageal reflux disease== | ||
===General=== | ===General=== | ||
| Line 253: | Line 235: | ||
*Doxycycline. | *Doxycycline. | ||
=Preneoplastic= | |||
==Barrett's esophagus== | |||
===General=== | |||
*Diagnosis is clinical. | |||
**Pathologic correlate: | |||
***Metaplastic transformation of stratified squamous epithelium to simple columnar epithelium with goblet cells. | |||
*Associated with chronic reflux. | |||
====Significance of Barrett's esophagus==== | |||
*Increased risk of adenocarcinoma of the esophagus. | |||
**Need on-going surveillance, i.e. long term follow-up/repeat esophagogastroduodenoscopy. | |||
===Microscopic=== | |||
Features: | |||
*Columnar epithelium. | |||
*Goblets cells -- '''key feature'''. | |||
Images: | |||
*[http://commons.wikimedia.org/wiki/File:Barretts_alcian_blue.jpg Barrett's esophagus - alcian blue (WC)]. | |||
=Neoplastic= | |||
==Dysplasia== | ==Dysplasia== | ||
===Classification=== | ===Classification=== | ||
| Line 281: | Line 284: | ||
*Presence of goblet cells is mildly reassuring its not dysplasia.<ref>GAG. January 2009.</ref> | *Presence of goblet cells is mildly reassuring its not dysplasia.<ref>GAG. January 2009.</ref> | ||
=Cancer= | |||
==General== | |||
*Proximal esophagus: [[squamous cell carcinoma]]. | *Proximal esophagus: [[squamous cell carcinoma]]. | ||
*Distal esophagus: adenocarcinoma arising from Barrett's esophagus. | *Distal esophagus: adenocarcinoma arising from Barrett's esophagus. | ||
| Line 290: | Line 293: | ||
*Barrett's esophagus. | *Barrett's esophagus. | ||
*Smoking. | *Smoking. | ||
==Squamous cell carcinoma== | |||
{{Main|Squamous carcinoma}} | |||
Like squamous cell carcinoma elsewhere. | |||
==Adenocarcinoma of the esophagus== | ==Adenocarcinoma of the esophagus== | ||
| Line 329: | Line 336: | ||
*CK7 +ve, CK20 +ve. | *CK7 +ve, CK20 +ve. | ||
=Weird stuff= | |||
*Inflammatory polyp - assoc. trauma/previous intervention. | *Inflammatory polyp - assoc. trauma/previous intervention. | ||
*Giant fibrovascular polyp - loose connective tissue covered with squamous epithelium. | *Giant fibrovascular polyp - loose connective tissue covered with squamous epithelium. | ||
| Line 351: | Line 358: | ||
*[http://commons.wikimedia.org/wiki/File:Granular_cell_tumor_(4)_S-100.JPG GCT - S100 (WC)]. | *[http://commons.wikimedia.org/wiki/File:Granular_cell_tumor_(4)_S-100.JPG GCT - S100 (WC)]. | ||
=See also= | |||
*[[Stomach]]. | *[[Stomach]]. | ||
*[[Gastrointestinal pathology]]. | *[[Gastrointestinal pathology]]. | ||
=References= | |||
{{reflist|2}} | {{reflist|2}} | ||
[[Category:Gastrointestinal pathology]] | [[Category:Gastrointestinal pathology]] | ||