Faculty of Allied Medical Sciences

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Faculty of Allied Medical Sciences

• Histopathology and Cytology
• MLHC-201

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THE PATHOLOGY OF THE GASTRO INTESTINAL TRACT

• Supervision
• Prof.Dr.Noha Ragab

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outcomes

• By the end of this lecture, the student will be
  able to understand the pathology of
  gastrointestinal tract and oral cavity

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THE PATHOLOGY OF THE ORAL CAVITY
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Benign Neoplasms

• PAPILLOMA
• Squamous papilloma is a benign, exophytic
  epithelial neoplasm composed of branching fronds
  of squamous epithelium with fibrovascular cores.

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Squamous Cell Carcinoma (SCC)

• 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 CAVITY

1. Dental ulcer traumatic ulcer by a sharp tooth
2. Aphthous ulcer very common Painful, recurrent,
   solitary or multiple, small ulcers. The lesion
   consists of a shallow ulcer covered by a
   fibrinopurulent exudate and inflammatory
   infiltrate.
3. Tuberculous ulcer an ulcer with undermined edges
   and caseous floor. It most commonly develops at
   the tip of the tongue. Coughed sputum containing
   bacilli leads to infection of the tongue
4. Malignant ulcer the ulcer edges are raised and
   everted, the floor of ulcer is rough, necrotic
   and the base of the ulcer is indurated.

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Salivary Glands
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ENLARGEMENT

• Unilateral enlargement of major salivary glands
  is usually caused by cysts, stones, inflammation,
  or neoplasms.
• Bilateral enlargement is due to inflammation
  (mumps, Sjögren syndrome), granulomatous disease
  (Saroidosis), or diffuse neoplastic involvement
  (leukemia or malignant lymphoma).

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SIALOLITHIASIS

• Stones occur in salivary gland ducts, mostly in
  the sub-mandibular gland. The most important
  consequence of stone formation 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 Gland Neoplasms
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A- Pleomorphic Adenoma (Mixed Tumor)

• Pathology
• Pleomorphic adenoma is a slowly growing,
  painless, movable, firm mass that has a smooth
  surface.
• Microscopically the tumors show epithelial
  tissue intermingled with myxoid or chondroid
  areas, reflecting a mixture of epithelial and
  mesenchymal components.

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Malignant Salivary Gland Tumors
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Mucoepidermoid Carcinoma

• Mucoepidermoid carcinoma is a malignant salivary
  gland tumor composed of a mixture of neoplastic
  epidermoid cells, mucus-secreting cells, and
  epithelial cells of an intermediate type.
• Grossly
• Mucoepidermoid carcinoma grows slowly and
  presents as a firm painless mass.
• Microscopically
• Tumors form irregular solid, duct-like and cystic
  spaces, 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 to
  invade locally and recur after surgical
  resection.

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• Pathology
• The tumor cells are small, have scant cytoplasm,
  and grow in solid sheets or as small groups,
  strands, or columns.
• Within these structures, the tumor cells
  interconnect to enclose cystic spaces, resulting
  in a solid, tubular or cribriform (sieve-like)
  arrangement.

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ESOPHAGUS
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Congenital disorders

• Tracheosophageal fistula congenital connection
  between the esophagus and trachea
• Esophageal webs web-like protrusions of the
  esophageal mucosa into the lumen
• Achalasia failure of the lower esophageal
  spincter (LES) to relax with swallowing

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• Esophageal varices
• Diltated submucosal veins in the lower third of
  the esophagus, usually secondry to portal
  hypertension.
• Cause liver cirrhosis
• Clinically massive hematemesis when ruptured
• Complication potentially fatal hemorrhage

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Esophagitis
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Gasteroesophageal reflux disease (reflux
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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Questions

• Complete
• 1-Adenoid Cystic Carcinoma is
• 2- Clinical presentation of scc is..
• 3- Bilateral enlargement is due to..
• 4- Adenoid cystic carcinoma is .with a
  tendency to.

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Assignments

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• Thank You