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Gastrointestinal system

Gastrointestinal system. The mouth. Teeth (caries) Action of Streptococci on dietary sugars Leads to pulpitis and abscess. Oral mucosa. Squamous epithelium Subject to infection Herpes virus Candida Hairy leukoplakia (HIV associated – caused by EBV). Oral cancer.

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Gastrointestinal system

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  1. Gastrointestinal system

  2. The mouth • Teeth (caries) • Action of Streptococci on dietary sugars • Leads to pulpitis and abscess

  3. Oral mucosa • Squamous epithelium • Subject to infection • Herpes virus • Candida • Hairy leukoplakia (HIV associated – caused by EBV)

  4. Oral cancer • Associated with tobacco (chewing) and alcohol • Clinical preinvasive lesion (leukoplakia) • Squamous carcinoma • Poor prognosis unless detected early

  5. Sites of oral cancer • Floor of mouth • Side of tongue • Palate • Back of tongue

  6. “Field cancerisation” • High rate of multifocal tumour • 5 year survivor has a 35% chance of developing a new primary tumour

  7. Salivary glands • Sialadenitis • Viral (mumps) • Bacterial, associated with: • Dry mouth • Duct obstruction by stones

  8. Salivary tumours • Benign: • Pleomorphic adenoma • Warthin’s tumour • Malignant: • Muco-epidermoid tumour • Adenoid cystic carcinoma • Adenocarcinoma

  9. Tumours • In the bigger glands most tumours are benign • More often malignant in minor salivary glands

  10. Pleomorphic adenoma • Most common salivary tumour • Mucoid “cartilagenous” stroma with epithelial proliferation • Prone to local recurrence

  11. Warthin’s tumour • Columnar epithelium with lymphoid stroma • Benign

  12. Adenoid cystic carcinoma • Epithelial cell islands with microcystic change • Very locally infiltrative (especially around nerves) but metastasises late

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