Pathology of oesophagus and cardia

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Pathology of oesophagus and cardia by Mind Map: Pathology of oesophagus and cardia

1. Achalasia (Neuromuscular dysfunction)

1.1. Definition

1.1.1. failure of relaxation of lower oesophageal sphincter

1.1.2. aperistalsis

1.2. Pathophysiology

1.2.1. loss of myenteric ganglion cells

1.3. Complications

1.3.1. Subsequent dilation of esophagus

1.3.2. Fibrosis and thickening of esophagus

1.3.3. Chronic esophagitis

1.3.4. Aspiration pneumonia

1.3.5. Predisposition to malignancy

1.4. Clinical features

1.4.1. Progressive dysphagia

1.4.2. Regurgitation

2. Neoplasia of Esophagus/ Carcinoma of Esophagus

2.1. Etiology

2.1.1. Diet

2.1.2. Chronic alcoholism

2.1.3. Tobacco smoking

2.1.4. Barrett's esophagus

2.1.5. Achalasia

2.1.6. Genetic predisposition

2.2. Histological Appearance

2.3. Gross Appearance

2.3.1. Polypoid or fungating

2.3.2. Ulcerative

2.3.3. Sclerosing or constrictive

2.4. Way of Spreading

2.4.1. Direct

2.4.2. Lymphatic

2.4.2.1. Regional lymph nodes

2.4.2.2. Submucosal spread

2.4.3. Hematogenous

2.5. Classification

2.5.1. Primary

2.5.1.1. Benign

2.5.1.1.1. Squamous papilloma

2.5.1.1.2. Lipoma

2.5.1.1.3. Leiomyoma

2.5.1.2. Malignant

2.5.1.2.1. Squamous cell carcinoma (SCC)

2.5.1.2.2. Adenocarcinoma

2.5.2. Secondary

2.5.3. Well, moderately, poorly differentiated

2.6. Multiple tumours/ carcinoma

3. Miscellaneous

3.1. Esophageal varices

3.1.1. Portal hypertension

3.2. Liver cirrhosis

4. Esophagitis

4.1. Congenital anomalies

4.2. Infective Esophagitis

4.2.1. Fungal Esophagitis

4.2.1.1. Candida

4.2.1.2. Aspergillus

4.2.1.3. Mucor

4.2.2. Viral Esophagitis

4.2.2.1. Herpes simplex virus

4.2.2.2. Cytomegalovirus

4.3. Reflux Esophagitis

4.3.1. Symptoms

4.3.1.1. Heartburn

4.3.1.2. Regurgitation

4.3.2. Causes

4.3.2.1. Hiatus hernia

4.3.2.1.1. Causes

4.3.2.2. Increased intra-abodminal pressure

4.3.2.3. Abnormal upper gastrointestinal motility

4.3.3. Complications

4.3.3.1. Peptic ulcer

4.3.3.2. Barrett's esophagus

4.3.3.3. Acute esophagitis

4.3.4. Morphology

4.3.4.1. Polymorphs in hyperplastic epithelium

4.4. Barrett's esophagus

4.4.1. Cause

4.4.1.1. Prolonged reflux esophagitis

4.4.2. Pathogenesis

4.4.3. Hallmark

4.4.3.1. intestinal metaplasia

4.4.3.2. presence of goblet cells

4.4.4. Consequences

4.4.4.1. Peptic ulcer

4.4.4.2. Malignancy/ Adenocarcinoma

4.5. Others (irritants, radiation, prolonged gastric intubation)

5. Cardia cancer

5.1. Adenocarcinoma

5.2. Predisposing factor: Barrett's esophagus