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Difference between revisions of "Esophagus"
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[[Image:Tractus intestinalis esophagus.svg|thumb|250px|A schematic of the esophagus.]] | |||
'''Esophagus''' connects the pharynx to the [[stomach]]. It is afflicted by tumours on occasion. Probably the most common affliction is [[gastroesophageal reflux disease]] (GERD). Most biopsies revolve around the questions: 1. intestinal metaplasia? 2. dysplasia? and 3. cancer? | '''Esophagus''' connects the pharynx to the [[stomach]]. It is afflicted by tumours on occasion. Probably the most common affliction is [[gastroesophageal reflux disease]] (GERD). Most biopsies revolve around the questions: 1. intestinal metaplasia? 2. dysplasia? and 3. cancer? | ||
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==Sign out== | ==Sign out== | ||
===Nonspecific inflammation=== | |||
<pre> | |||
Esophagus, Distal, Biopsy: | |||
- Columnar epithelium with moderate chronic inflammation. | |||
- Reactive squamous epithelium. | |||
- NEGATIVE for intestinal metaplasia. | |||
- NEGATIVE for dysplasia and NEGATIVE for malignancy. | |||
</pre> | |||
====Block letters==== | |||
<pre> | <pre> | ||
ESOPHAGUS, DISTAL, BIOPSY: | ESOPHAGUS, DISTAL, BIOPSY: | ||
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| | | | ||
| incr. risk of Barrett's | | incr. risk of Barrett's | ||
| | | [[Image:Gastroesophageal reflux disease -- low mag.jpg|center|thumb|125px|c/w GERD. (WC)]] | ||
|- | |- | ||
|[[Eosinophilic esophagitis]] | |[[Eosinophilic esophagitis]] | ||
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| | | | ||
| incr. risk of carcinoma | | incr. risk of carcinoma | ||
| | | [[Image:Low-grade columnar dysplasia of the esophagus -- intermed mag.jpg|thumb|110px|LGH - intermed. mag.]] | ||
|- | |- | ||
| [[Columnar dysplasia of the esophagus|Dysplasia, high grade]] | | [[Columnar dysplasia of the esophagus|Dysplasia, high grade]] | ||
| | | [[cribriform]]ing and/or necrosis | ||
| nuclei often round & large, hyperchromasia | | nuclei often round & large, hyperchromasia | ||
| | | | ||
| marked incr. risk of carcinoma | | marked incr. risk of carcinoma | ||
| | | [[Image:High-grade columnar dysplasia of the esophagus -- high mag.jpg|thumb|110px|HGD - high mag.]] | ||
<!-- | <!-- | ||
|Entity | |Entity | ||
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| - | | - | ||
| - | | - | ||
| Image | | [[Image:Tinci%C3%B3n_hematoxilina-eosina.jpg|center|thumb|125px|Normal esophagus. (WC)]] | ||
|- | |- | ||
|Barrett's esophagus | |Barrett's esophagus | ||
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| - | | - | ||
| follow-up | | follow-up | ||
| Image | | [[Image:Low-grade columnar dysplasia of the esophagus -- intermed mag.jpg|thumb|110px|LGH - intermed. mag.]] | ||
|- | |- | ||
|High-grade columnar dysplasia | |High-grade columnar dysplasia | ||
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|Intramucosal adenocarcinoma | |Intramucosal adenocarcinoma | ||
| no maturation | | no maturation | ||
| single cells or '''back-to-back irregular glands''' with budding and/or ''' | | single cells or '''back-to-back irregular glands''' with budding and/or '''[[cribriform]]ing''' and/or '''gland dilation''' or glands with long axis along muscularis mucosae | ||
| moderate-to-marked nuclear atypia - usu. round large nuclei, hyperchromasia, +/-necrosis | | moderate-to-marked nuclear atypia - usu. round large nuclei, hyperchromasia, +/-necrosis | ||
| - | | - | ||
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*[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)]. | ||
= | =Non-neoplastic disease= | ||
The group of conditions doesn't fit neatly with the others. It is a mixture of different non-neoplastic conditions. | The group of conditions doesn't fit neatly with the others. It is a mixture of different non-neoplastic conditions. | ||
==Gastroesophageal reflux disease== | ==Gastroesophageal reflux disease== | ||
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==Benign esophageal stricture== | ==Benign esophageal stricture== | ||
{{Main|Esophageal stricture}} | {{Main|Esophageal stricture}} | ||
==Esophageal duplication cyst== | |||
{{Main|Foregut duplication cyst}} | |||
==Zenker's diverticulum== | |||
{{Main|Zenker's diverticulum}} | |||
*[[AKA]] ''cricopharyngeal diverticulum'', ''pharyngoesophageal diverticulum'' and ''hypopharyngeal diverticulum''. | |||
==Radiation esophagitis== | |||
{{Main|Radiation esophagitis}} | |||
=Preneoplastic= | =Preneoplastic= | ||
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==Squamous dysplasia of the esophagus== | ==Squamous dysplasia of the esophagus== | ||
*[[AKA]] '' | *[[AKA]] ''esophageal squamous dysplasia''. | ||
===General=== | ===General=== | ||
*Precursor of [[esophageal squamous cell carcinoma]].<ref name=pmid11936262>{{Cite journal | last1 = Dry | first1 = SM. | last2 = Lewin | first2 = KJ. | title = Esophageal squamous dysplasia. | journal = Semin Diagn Pathol | volume = 19 | issue = 1 | pages = 2-11 | month = Feb | year = 2002 | doi = | PMID = 11936262 }}</ref> | *Precursor of [[esophageal squamous cell carcinoma]].<ref name=pmid11936262>{{Cite journal | last1 = Dry | first1 = SM. | last2 = Lewin | first2 = KJ. | title = Esophageal squamous dysplasia. | journal = Semin Diagn Pathol | volume = 19 | issue = 1 | pages = 2-11 | month = Feb | year = 2002 | doi = | PMID = 11936262 }}</ref> | ||
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==Glycogenic acanthosis of the esophagus== | ==Glycogenic acanthosis of the esophagus== | ||
{{Main|Glycogenic acanthosis of the esophagus}} | |||
==Achalasia== | ==Achalasia== | ||
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*[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3197178/figure/fig4/ Esophageal inlet patch (nih.gov)].<ref name=pmid22091379>{{Cite journal | last1 = Behrens | first1 = C. | last2 = Yen | first2 = PP. | title = Esophageal inlet patch. | journal = Radiol Res Pract | volume = 2011 | issue = | pages = 460890 | month = | year = 2011 | doi = 10.1155/2011/460890 | PMID = 22091379 }}</ref> | *[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3197178/figure/fig4/ Esophageal inlet patch (nih.gov)].<ref name=pmid22091379>{{Cite journal | last1 = Behrens | first1 = C. | last2 = Yen | first2 = PP. | title = Esophageal inlet patch. | journal = Radiol Res Pract | volume = 2011 | issue = | pages = 460890 | month = | year = 2011 | doi = 10.1155/2011/460890 | PMID = 22091379 }}</ref> | ||
== | ===Sign out=== | ||
<pre> | |||
Esophagus at 22 cm, Biopsy: | |||
- Gastric type mucosa with mild chronic inactive inflammation, see comment. | |||
- Scant unremarkable squamous epithelium. | |||
- NEGATIVE for intestinal metaplasia. | |||
- NEGATIVE for dysplasia. | |||
Comment: | |||
This is in keeping with an "inlet patch", also known as "heterotopic gastric mucosal patch of the proximal esophagus". | |||
</pre> | |||
== | ==Squamous papilloma of the esophagus== | ||
{{Main|Squamous papilloma of the esophagus}} | |||
=See also= | =See also= | ||