Oral and Esophageal Pathology

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

Oral and Esophageal Pathology

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