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GASTROINTESTINAL PATHOLOGY

GASTROINTESTINAL PATHOLOGY. OESOPHAGUS AND STOMACH. GUT LINING EPITHELIUM. COLUMNAR SQUAMOUS. OESOPHAGUS. NON-KERATINISING STRATIFIED SQUAMOUS. STOMACH. BODY AND FUNDUS: SPECILIALISED (Chief cells and parietal cells) ANTRUM : MUCUS SECRETING. OESOPHAGUS AND STOMACH

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GASTROINTESTINAL PATHOLOGY

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  1. GASTROINTESTINALPATHOLOGY OESOPHAGUS AND STOMACH

  2. GUT LINING EPITHELIUM COLUMNAR SQUAMOUS

  3. OESOPHAGUS NON-KERATINISING STRATIFIED SQUAMOUS

  4. STOMACH

  5. BODY AND FUNDUS: SPECILIALISED (Chief cells and parietal cells) ANTRUM: MUCUS SECRETING

  6. OESOPHAGUS AND STOMACH HISTOPATHOLOGY

  7. OESOPHAGUS REFLUX BARRETT’S OESOPHAGUS EOSINOPHILIC OESOPHAGITIS CARCINOMA

  8. REFLUX/ GORD/ GERD Clinical definition – based on symptoms Poor correlation with histological findings ENDOSCOPY: NORMAL EROSIVE NON EROSIVE

  9. GORD- ROLE OF HISTOLOGY • Correlate with endoscopic findings • Consider other diagnoses: • eg EOSINOPHILIC OESOPHAGITIS • BARRETT’S OESOPHAGUS

  10. REFLUX ENDOSCOPIC FEATURES HISTOLOGY BASAL HYPERPLASIA (>15%) ELONGATION OF PAPILLAE (>2/3) EOSINOPHILS/ NEUTROPHILS CAPILLARY CONGESTION (Gastroenterology 1970 58: 163-174)

  11. BARRETT’S OESOPHAGUS

  12. DEFINITION ▸ Barrett’s oesophagus is defined as an oesophagus in which any portion of the normal distal squamous epithelial lining has been replaced by metaplastic columnar epithelium, which is clearly visible endoscopically (≥1 cm) above the GOJ and confirmed histopathologically from oesophageal biopsies www.bsg.org.uk

  13. NORMAL BARRETT’S

  14. BARRETTT’S MUCOSA (METAPLASIA) DYSPLASIA (LOW GRADE) DYSPLASIA (HIGH GRADE) ADENOCARCINOMA

  15. WWW.bsg.org.uk

  16. EOSINOPHILIC OESOPHAGITIS

  17. Eosinophilic oesophagitis “ chronic, immune-mediated, .. oesophageal dysfunction ….characterised by eosinophil-rich inflammation”

  18. OEDEMA • INFLAMMATION HISTOLOGY: 15 EOSINOPHILS/HPF

  19. OESOPHAGEAL CARCINOMA WHO CLASSIFICATION 2010 SQUAMOUS CARCINOMA ADENOCARCINOMA RARE: ADENOID CYSTIC, ADENOSQUAMOUS, BASALOID SCC, MUCOEPIDERMOID, SPINDLE CELL SQUAMOUS, VERRUCOUS CARCINOMA UNDIFFERENTIATED NEUROENDOCRINE (NET AND NEC)

  20. OESOPHAGEAL TUMOURSNON-EPITHELIAL WHO CLASSIFICATION 2010 MESENCHYMAL eg GIST LYMPHOMAS SECONDARY

  21. STOMACH GASTRITIS GASTRIC POLYPS GASTRIC ADENOCARCINOMA

  22. GASTRITIS ACUTE: NSAID, STRESS, ALCOHOL CHRONIC A- AUTO-IMMUNE B- BACTERIAL C- CHEMICAL

  23. HISTOLOGY NORMAL ACUTE CHRONIC GASRITIS 0THER CHRONIC : A /B/ C ATROPHY: YES/ NO INTESTINAL METAPLASIA: YES/ NO

  24. GASTRIC POLYPS FUNDIC GLAND CYST POLYPS HYPERPLASTIC POLYPS ADENOMAS OTHERS

  25. GASTRIC TUMOURSWHO CLASSIFICATION 2010 EPTITHELIAL: ADENOMAS ADENOCARCINOMA NEUROENDOCRINE MESENCHYMAL (CONNECTIVE TISSUE TUMOURS): GIST LEIOMYOMA OTHERS LYMPHOMAS OTHERS

  26. GASTRIC TUMOURSWHO CLASSIFICATION 2010 EPITHELIAL TUMOURS Benign Epithelial tumours: adenoma/ adenocarcinoma Malignant Epithelial tumours (adenocarcinoma): Tubular Papillary Mucinous Signet ring Mixed Grade: (tubular and papillary only)

  27. GASTRIC ADENOCARCINOMA OTHER (SIMPLIFIED) CLASSIFICATION INTESTINAL TYPE- GRADE DIFFUSE

  28. GASTRIC TUMOURS NEUROENDOCRINE TUMOURS NET NEC MIXED (MANEC)

  29. STAGING OF GASTRIC TUMOURS TNM7 STAGING for: ADENOCARCINOMA NET/ NEC GIST

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