git prelab tnx full
Post on 06-Apr-2018
244 Views
Preview:
TRANSCRIPT
8/3/2019 Git Prelab Tnx Full
http://slidepdf.com/reader/full/git-prelab-tnx-full 1/7
1
GIT Prelab
36 y/o female, recurrent epigastric pain withmassive hematemesis
Hematemesis vomiting of blood
blood is typically brownish and frothyHemoptysis
comes from the lungs
blood is bright red (due to it being fresh)
Ulcer
the lesion in the photo
complete loss of epithelium
submucosa is exposed
if due to Peptic Ulcer Disease (PUD),borders are regular and the base is smooth
if due to malignancy, or if having malignantpotential, borders are heaped up (meaningthere is an elevation in the border)
Erosion
loss of epithelium is superficial
submucosa still hidden
Peptic Ulcer
Peptic Ulcer Disease (PUD)
borders are regular
base is smooth
submucosa, and even muscularis area isexposed, meaning this is in fact an ulcer
a. Necrotic debris
b. Acute inflammation inflammatory cell infiltrates may be found
cells may be acute or chronic, depending onthe activity of the ulcer
c. Granulation tissue
normal process/response of the body torepair injury (in this case[ulcer], there isvascularization and fibrosis)
differerent from granuloma: ream oflymphocytes, activated macrophages(epitheloid cells), multinucleated giant cells
d. Fibrosis
Complications: perforation
obstruction o edema o fibrosis o depends on ulcer location
if ulcer is located near anopening (e.g. pyloricopening, ulcer in the antralarea), if the ulcer forms anelevated lesion, it maycause obstruction
sepsis o if perforated, it could cause
peritonitis, causing sepsis
rupture
hemorrhage o due to exposure of the blood
vessels
anemia o due to chronic bleeding
45 y/o, male
Subject: Patho LabTopic: GITLecturer: Dr. Bautista
Date of Lecture: Nov. 10, 2011Transcriptionist: PinkyredPages: 7 S
Y
2 0 1 1 - 2 0 1 2
8/3/2019 Git Prelab Tnx Full
http://slidepdf.com/reader/full/git-prelab-tnx-full 2/7
2
Benign lesion
well demarcated borders
no area of necrosis punctate areas of hemorrhages are possible
even in benign lesions
Gastrointestinal Stromal Tumor (GIST)
mucosa may be normal or ulcerated (thereis a visible bulge [elevated area], but themucosa is still normal)
neoplasm in the stroma pushes the mucosaupward or outward, but mucosal lining isnormal
histologically
uniform population of spindle cells
very few pleomorphisms
cells look alike
cytoplasms may be delineated
75 y/o male, epigastric fullness, weight loss,black tarry stool
Melena
black tarry stoolBased on the history, lesion is in the pyloric area ofthe stomach
lesions in the pyloric area are likely to causeobstructions because the opening is small,and there is a muscular sphincter
Malignant lesion
necrosis
bleeding
irregular border
Adenocarcinoma, pyloric area
Adenocarcinoma
most common GIT tumor
more common in the colon
Well-differentiated carcinoma
glands and granular formation are seen
glands are compact, forming cribriformpatterns, sieve-like (there are “holes” allover)
8/3/2019 Git Prelab Tnx Full
http://slidepdf.com/reader/full/git-prelab-tnx-full 3/7
3
22 y/o male, severe abdominal pain
Meckel’s diverticulum
shown in the photo
congenital
pathogenesis: failure of vitelline duct toinvolute
a true diverticulum
involves all layers
lined by gastric mucosa, sometimes withnon-malignant pancreatic tissue
usually located at the antimesenteric side(opposite side of where the mesentery is)
Colonic diverticulum
pathogenesis: invagination of the wall,usually in the colon (due to it having 2layers: inner circular, outer longitudinal)
not a true diverticulum
does not involve all layers
68 y/o male, severe abdominal pain, vomitingand diarrhea
gangrenous
could be an infarction caused byo hypoxic injury
mechanical obstruction intussusception volvulus adhesion hernia
would not causeinfarctionimmediately
would incarceratefirst, thenstrangulate
o reperfusion injury
histologicallyinfarction/gangrene
mucosa is already necrotic anddeluded(being detached from the lining)
there are thrombosed veins in submucosa
inflammation extends to serosa(inflammatory cells: acute or chronicdepends on the onset of injury)
congestion/hemorrhages
mucosa is normal affects only the submucosa
8/3/2019 Git Prelab Tnx Full
http://slidepdf.com/reader/full/git-prelab-tnx-full 4/7
4
33 y/o male, abdominal enlargement
patient also manifested with chronic cough (>2weeks) and hemoptysis
diagnosis: ileocecal tuberculosis
On closer view, granuloma and giant cells may beseen
chronic granulomatous formation
64 y/o, abdominal enlargement, small scantyhard stool
Multiple cervical lymphadenopathy- NonHodgkin’s lymphoma
@ scanning view- take note of diffuse proliferation ofmalignant cell, no demarcation@ hpo- uniform population of malignant cell,presence of prominent nucleoli, pleomorphism
*NHL
Mixed hemorrhoids-possible liver failure -portal hypertension, backflow of blood at tributaries,@ egd-possible esophageal varices
Infectious- causative agent: EntamoebahistolyticaAmebic colitis- flask shape ulcer, @ base- cyst andtrophozoite
Juvenile Polyp
@ microscope-cystic dilation of glands
No malignant potential
8/3/2019 Git Prelab Tnx Full
http://slidepdf.com/reader/full/git-prelab-tnx-full 5/7
5
Villus- fingerlike projection
@ submucosa invading-high malignantpotential
Right sided malignancy- Carcinoma ( epithelialorigin) @
Ileocecal junctionMUCINOUS ADENOCARCINOMA
*L sided vs R sided malignancy- napkin ring Right sided- fungating, capacious at cecum, withspace, with enlargement but no obstruction, itoutgrows the blood supply causing necrotic sitearea, which is site for bleedingManifestation- anemia due to bleedingLeft sided- napkin ring lesion, narrowing of lumen,presentation-obstruction, goat stool like stool
Pinkish/purplish-mucin
Floating cells- malignant cells floating inlakes /pools of mucin
Invades the submucosa, full thickness ofcolonic wall or sometimes extending tocolonic fat
Pigmented: melanoma- can be at back,perineal area, scalp
Clusters of malignant cells with pigment
Malignant version of gist
Gist- leiomyoma+ spindle cells
Grossly with hemorrhages
8/3/2019 Git Prelab Tnx Full
http://slidepdf.com/reader/full/git-prelab-tnx-full 6/7
6
Diagnosis: Appendicitis
RUQ pain : differentialsFemale: ectopic pregnancy, salphingitisMale: meckel’s diverticulum ( 2ft from ileocecalarea)- may rupture and inflamed and may present asRUQ pain
Section taken from the appendix
Malignant-glandular
Adenocarcinoma of the Appendix
More common tumor/ malignancy of theappendix: carcinoid, usually found at thetip of the appendix
___________END OF TRANX____________
top related