#pathology
GIT
الشيت ال3 مانزلتش د. عبير ركزت عليه كله

اختي من الدفعة 47 قالتلي دكتورة عبير تركز علي inflammatory bowel diseases والgastritis

🚩 Aphthous ulcers : (canker sores)
✔painful and recurrence
✔associated with: celiac disease & Behçet disease.
🚩Herpes simplex virus infection >>>> type 1.HSV1
Precancer condition: seq.cell.C
✔ leukoplakia
✔erythroplakia 🚫 most serious
🚩To different between candidiasis and leukoplakia ;
Leukoplakia can't scraped !✔✔
📌Seq.cell carcinoma in oral cavity 95%
✔mutation of TP53
✔HPV16
🚩Pyogenic granuloma >>> pregnancy tumor
🚩Sialadenitis : inflammation of salivary glands....
✔mucocele
✔repture duct
📌 pleomorphic adenoma 50% Bengin
📌mucoepidermoud carcinoma 15% malignant
📌Pleomorphic adenoma are non capsulated (capsula not fully developed)
📌 Achalasia; no relaxation/functional obstruction
🚩 ectopia: common in git ,
(Gastric mucosa in upper third of esophagus )
🚩Esophageal varices: in lower third
✔ dilated....portal circulation
✔Hematemesis
🚩esophageal varices;
Medical fatal, ( emergency)
🚩esophagitis --> precancer..
♦️ reflex esophagitis >> barrett esophagus
📌Mallory weiss tears;: sever vomiting
🚩 barrett esophagus: metaplasia >>>
✔adaptation
✔dysplasia >>precancer >> cancer.
🚩coffee ground hematemesis:
In clinical features of gastropathy /acute gastritis.
🔹️H . Pylori:
✔Adenocarcinoma
✔lymphoma
🚩hyperplastic Polyps must be distinguish from sessile serrated adenoma..by microscopic ↔️
🔹️Hyperplastic: serrated surface )
🔹️adenoma : serrated full length of glands
⚠️ impo
✔morphology of adenoma
✔colorectal carcinoma
✔gastric adenocarcinoma
🔹️Hyperplastic Polyps ↪ left colon &rectum
🔹️Adenoma ↪ right colon
🚩tumors in the proximal colon (right) often grow as polypoid ,exophytic masses; these tumors rarely cause obstruction.
🚩carcinomas in the distal colon (left) tend to be annular lesions that produce "napkin ring:" constructions and luminal narrowing
♦️Iron Deficiency anaemia/old male or postmenopausal female 👇🏼
Is gastrointestinal cancer until proven otherwise
⚠️ impo case !
📌changes in bowel habits:;
Left sided colorectal adenocarcinomas (may produce occult bleeding)
⚠️ impo case!
✔ pain in right lower quadrant
📌nausea, vomiting, low grade fever, mild elevated peripheral white blood cell count .
⬇️
Acute appendicitis

📌 mucocele :
Oral cavity
Appendix

✔ celiac disease " celiac sprue"
Gluten sensitive enteropathy
🚩 intussusception:
▫️Telescoped segment >>>intussusceptum
▫️lower receiving segment >> intussuscipiens
♦️Ischemic bowel disease resulting from hypoperfusion is most common at the splenic flexure , segmoid colon , and rectum:🔹️water shed zones :
Where tow arterial circulation terminate...
🔹️Inflammatory bowel disease:
✔Chronic condition
✔ microbiota
Immunity
Familial
✔CD &UC
✔extraintestinal manifestation
✔⚠️Ashkenazi
🔹️gastric adenocarcinoma
✔ intestinal >> APC
✔ DIFFUSE >>> CDH1
✔In gastric adenocarcinoma diffuse type:;
♦️ leather bottles ↪ linitis plastica
♦️Prognosis of gastric adenocarcinoma;
✔ based on depth of invasion. (Eraly or advanced)
✔more lymph nodes more stage
✔ distant metastatic
✔ infiltration
🔹️ carcinoid "gastric tumors"
Uniform cells with scant
🔹️chronic gastritis most common cause;:
H-pylori
Autoimmune
♦️complications of chronic gastritis:
✔peptic ulcer disease
✔mucosal atrophy and intestinal metaplasia
✔Dysplasia
✔Gastritis cystica

📌gastropathy : hypertrophy
🚩 inflammatory and hyperplastic Polyps 75%.
🚩fundic glands polyps never progress to malignant : protons pump inhibitors.
📌gastric adenocarcinoma 90%
📌peptic ulcer not become cancer.
🚩PUD .the residual gastric stump.. become cancer.
تجميعات من 47
#pathology

📌Liver injury ^degeneration :
a-ballooning (swollen hepatocyte)
b-foamy (hepatocyte containing bile)
c-steatosis(fat droplet in hepatocyte)
📌necrosis of liver : councilman bodies:
centrilobular -focal-piecemeal -massive
📌Cirrhosis↪end of chronic liver Dis
📌massive hepatic necrosis or cirrhosis lead to↪hepatic failure
📌fibrosis:response to inflammation ➡irreversible(nodule of regenerating hepatocyte surrounded by fibrous band↔️Cirrhosis
📌 most common cause micronodular cirrhosis ↔️ alcohol
♦️Grigler-Nijjar 1 syndrome
No Glucoronyl transferase ✔️

♦️Gilbert syndrome
Mutation in Glucoronyl transferase ✔️
✔ Risk factor of hepato cellural carinoma :
🔹️HBV ,, HCV
🔹️Aflatoxin ,, Alcoholism
🔹️Cirrhosis ,, Carcinogene substance
✔most common benign lesions of the liver
are hemangiomas
✔commonest primary malignancy
Hepatocellular carcinoma
✔most common hepatic neoplasm are
metastatic carcinomas
✔ hemangiomas Can cause severe intra-abdominal bleeding
📌 Benign tumour of liver:
1. hemangioma ( more common )
2. Adenom
📌 Malignant Liver tumour :

1.( HCC) Hepato cellular carcinoma commonest primary tuomor ✔

2.Metastatic carcinoma ( most common hepatic neoplasm )
📌hepatitis
caused by
1/A;B;C;D;E;F;viruse
rarely by
2/ EPstein Barr viruse;
3/HCV;
4/CMV
5/autoimmume
6/drugs&toxin
7/alcohol
♦️HAV......
RNA-benign-self limited-
never cause chronic hepatitis
transmitted by feco/oral route
♦️HBV......
DNA-chronic hepatitis
-present in all body fluid exept stool..
spread by➡blood or body fluid contact
▫️Ground glass cell
▫️risk of hepatocellular carcinoma.
♦️HCV......
RNA
most common cause of transfusion associated hepatitis
⬆⬆risk of hepatocellular carcinoma
♦️autoimmune hepatitis
more in female
Type 1 :; associated ē ANA &ASMA
Type 2 :; associated ē anti LKM1
♦️fulminant hepatitis
massive loss of parenchyma with collapsed reticulin framework &
preserved portal tracts
in chronic aggressive
🔥alcoholic liver Disease:
1-fatty liver:
✔fat droplet accumulate in hepatocyte ✔hepatomegaly-elevated bilirubin&alkaline phosphatase.


2-alcoholic hepatitis
✔hepatocyte swelling & necrosis -mallory body! -
✔neutrophilic infiltration-fibrosis-
at the time of fibrosis appears the damage is irreversible.
✔-elevated liver enzyme-fever.

3-alcoholic cirrhosis

📌wilson's disease (AR)
▫️Copper accumulated in liver & brain
▫️inherited disorder of copper metabolism
▫️kayser-fleischer ring at corneal limbus.
▫️low serum caeruloplasmin
▬▬▬▬▬▬▬▬▬▬▬▬

#pathology

Liver cirrhosis
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