Gastrointestinal system

Gastrointestinal system By S.S Eghbali,MD,ApCp Bushehr 2009

Gastrointestinal pathology Part I • Mouth and oral cavity

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)

Premalignant lesions • Leukoplakia • Erythroplakia

Leukoplakia • Tubacco • Hpv infection • Chronic irritation • Alcohole • Special diets • Hyperkeratosis with or without dysplasia • Progress to Invasive scc upto 5-15%

Erythroplakia • Red &granular lesions • Severe dysplasia • Progress to invasive scc >50%

Oral cancers • <3% all visceral malignancies • Age >60 • Fatality>50% SCC is the most common type • Common sites: lip,palate,tongue • Lymphatic metas.: 50-60%

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

Salivary glands • Sialadenitis& sialolithiasis • Viral sialadenitis(mumps) • Bacterial sialadenitis • Dry mouth • Sialolithiasis(calculi) • Medical and surgical treatment

Autoimmune sialadenitis(Sjogrene syndrome) • Xerostomia • Keratoconjunctivitis(Sicca) • Sialoadenitis(painless swealing ) • Primary& secondary(lymphoma,leukemia,sarco-idosis,…)

Histopathology findings • Intrestitial Edema • Mono nuclear infiltration • Cell necrosis(bacterial infections)

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

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

Pleomorphic adenoma(Benign mixed tumor) • Most common salivary tumor • Slow growing • Encapsulated • Fascial nerve • Recurance>10% • Malig.transformation 15-40% • Bimodal Pattern • Glandular comp. • Stomal comp. • Origin: myoepithelial

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

Warthins tumor(papillary cystadenoma ,Cystadenolymphoma) • Common site: parotid • Encapsulated • Cyst&cleft • Benign with >10% recurrance • No malignant transformation • Cyst lined by epithelial lining • Lymphoid aggrgation

Warthin’s tumour • Columnar epithelium with lymphoid stroma • No malgnant transformation

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

Any Question?

Gastrointestinal system