Acute pancreatitisSudden inflammation and hemorrhaging of the pancreas due to the destruction by its own digestive enzymes (autodigestion). Etiology:- Biliary pancreatitis (e.g., gallstones, constriction of the ampulla ...
Akute Pankreatitis1. Interstitielles Ödem 2. Disseminierte Fettgewebsnekrosen: Das Fettgewebe setzt im Rahmen der Nekrose Fettsäuren frei, die hämatoxylinblaue Kalkablagerungen (Fettkalkspritzer) bilden 3. Nekrose 4. ...
Chronic pancreatitisPerisistent, chronic inflammation of the pancreas, often due to repeated bouts of acute pancreatitis.Distict histopathology! → Irreversible changes to the pancreatic structure: Fibrosis, atrophy, calcification ...
Chronische Pankreatitis1. Entzündungsinfiltrat 2. Nekrosezonen 3. Atrophie/Verlust des Drüsengewebes 4. Fibrose 5. Anomalien des Gangsystems (Stenose, Dilatation) 6. Verkalkungen
Pancreatic cancer- Age of onset: 60-80 years- More common in African Americans Risk factors: Smoking, obesity, high alcohol consumption, diet high in red meat, male gender, African American, age >65 years; diabetes, chronic ...
Duktales Pankreasadenokarzinom1. Tumorknoten: Kleindrüsig bis alveolärer Aufbau 2. Fibrose 3. Destruktives Wachstum, erhaltene endokrine Inseln 4. PAS-postives Material in den Tumorzellen 5. Nekrose
Serös-zystischer Pankreastumor- F > M- Alter: 35-90 Jahre- Lokalisation: Korpus, Schwanz (50-65%) (vgl. Pankreaskarzinom im Kopf)- Assoziation mit von Hippel Lindau Syndrom (Hämangioblastom, Nierenzellkarzinom, Phächromozytom) - ...
Muzinös zystischer Pankreastumor- F:M = 9:1- Alter: 20-80 Jahre- Lokalisation: Korpus, Schwanz (50-65%) - Zystischer Tumor mit einem zylindrischen schleimbildenden Epithel und ovariellem Stroma- Keine Beziehung zum Gangsystem Muzinös-zystisches ...
Intraduktaler papillär-muzinöser Tumor (IPMT)- Männer und Frauen- Alter: 40-80 Jahre- Lokalisation: Haupt- und/oder grössere Seitengänge - Assoziation mit anderen Malignomen (30%): Kolon- und Magenkarzinom Intraduktal papillär-muzinöser Tumor ...
Solider pseudopapillärer Tumor- F:M = 9:1- Alter: 8-60 Jahre- Lokalisation: Korpus/Schwanz des Pankreas Prognose: sehr gut
Normaler Ösophagus25-30 cm long tube from the pharynx to the stomach Histologie:- Mucosa:1. Nicht-verhornendes, mehrschichtiges Plattenepithel2. Lamina propria3. Muscularis mucosae (glatt)- Subserosa mit serösen Schleimdrüsen- ...
Esophageal cancerEtiology:- Adenocarcinoma: Gastroesophageal reflux (Barrett's esophagus), obesity, smoking, achalasia→ Localization: Lower 1/3- Squamous cell carcinoma: Smoking, alcohol, diet low in fruit and vegetables, ...
Esophagitis - Differential- Gastroesophageal reflux disease → Reflux esophagitis → Symptoms: Heartburn, regurgitation, coughing, feeling of lump in throat→ Endoscopy shows signs of erosions: Classification with Savary-Miller ...
Gastro-ösophageale RefluxkrankheitÄtiologie: Insuffizienz des unteren Ösophagussphinkters, erniedrigter Ruhetonus, Störungen der Peristaltik (Sklerodermie), erhöhter intraabdomineller Druck (Schwangerschaft, Ileus, Zwerchfellhochstand, ...
Infektiöse ÖsophagitisKandidaösophagitis:1. Geflecht (Myzel) aus Hyphen; deutlich erkennbar in Grocott-Versilberung2. Neutrophile Herpes-simplex Ösophagitis:1. Cowdry A Einschüsse2. Neutrophile3. Erosion/Ulzeration Cytomegalievirus ...
Barrett-ÖsophagusIntestinale Metaplasie (Zylinderepithel mit Becherzellen) oberhalb des gastro-ösophagealen Übergangs. Häufigkeit: 10% der Patienten mit symptomatischem gastro-ösophagealem Reflux Prag Klassifikation:- ...
Magen Histologie- Foveolae (pits)- Glandulae (glands): Dort, wo sich die Foveolae aufteilen - Hauptzellen (Chief cells): Sezernieren Pepsinogen- Belegzellen (Parietal cells): Produzieren HCl und Intrinsic Factor- Enterochromaffine ...
Gastrointestinaler Stromatumor (GIST)Mesenchymaler Tumor, der von den Cajal-Zellen des GI-Trakts ausgeht Lokalisation: - Magen (50-60%)- Dünndarm (20-30%)- Selten in Kolon, Rektum (5-10%), Ösophagus, Omentum Klinik:- Oft klein (<2 cm) ...
MALT-LymphomMucosa-Associated Lymphoid Tissue (MALT) lymphoma = Extranodal marginal zone lymphoma - Approx. 5% of Non-Hodgkin lymphomas- Peak incidence: 7th and 8th decades Etiology:- Gastric MALTomas: Association ...
Crohn's diseaseAverage age at diagnosis: 15-35 yearsRisk factors: - Nicotine abuse- Familial predisposition: Frameshift mutation in NOD2 gene, HLA-B27 association Symptoms: - Pain in right lower quadrant, diarrhea, ...
Morbus Crohn1. Schleimhauterosionen/Ulzera 2. Epitheloidzellige Granuloma ohne Nekrose 3. Transmurale Entzündung mit Fistelbildung 4. Gesamte Wand verdickt Keine Dysplasie des Schleimhautepithels (im Gegensatz zur ...
Ulcerative colitisMost common form of inflammatory bowel disease, where ulcers form along the inner surface or lumen of the large intestine (colon + rectum).- Risk factors: Family history, young women, Caucasians + Jews ...
Colitis ulcerosa1. Lokalisation der Veränderung: Nur Mukosa und Submukosa sind betroffen 2. Schleimhautulzera 3. Kryptenabszesse 4. Pseudopolypen: Inflammatorische Polypen 5. Epitheldysplasien
Peutz-Jeghers syndromeRare autosomal dominant condition- Mutation of the STK11 gene (tumor suppressor gene), expressed in a lot of tissues Individuals develop hamartomous polyps throughout their GI tract and melanotic macules ...
Colonic polypsBenign:- Hyperplastic polyps→ Most common; generally smaller and predominantly located in rectosigmoid region- Inflammatory polyps→ Due to mucosal erosion in inflammatory bowel disease.- Hamartomous ...
Colorectal carcinomaThird most common cancer in women and men. Etiology: - Premalignant polyps: adenomatous (APC mutation) and serrated polyps (defects in DNA repair genes)- Risk factors: Elderly, male, IBD, smoking, red ...
Lynch SyndromEtwa 2-5% aller CRC - Junge Patienten (<50 Jahre)- Oft rechtsseitig Pathogenese:- Keimbahnmutation in einem DNA Mismatchrepair-Gen - Praktisch immer BRAF Wildtyp. Assoziierte Karzinome: Endometrium (meist ...
Esophageal diverticulaLocalization:- Upper esophageal diverticulum: Pharyngoesophageal diverticulum→ Most common type: Zenker's diverticulum at Killian's triangle- Middle esophageal diverticulum: diverticulum at the tracheal ...
Portal hypertensionPortal venous pressure of >10 mm Hg (normal value: 3-6 mm Hg). Etiology:- Prehepatic→ Portal vein thrombosis→ Splenic vein thrombosis - Intrahepatic (most common)→ Cirrhosis including fibrous proliferation→ ...
Esophageal variceal hemorrhageEsophageal variceal hemorrhage refers to the bleeding of dilated sub-mucosal veins (varices) of the distal esophagus and is a dangerous consequence of portal hypertension. Clinical presentation:- Signs ...
Atrophic gastritisCondition characterized by chronic inflammation of the gastric mucosa with atrophy, gland loss, and metaplastic changes. Etiology: - Autoimmune metaplastic atrophic gastritis (AMAG)→ Associated with ...
Gastric cancer- Peak incidence: 70 years- High incidence in South Korea and Japan Etiology: - Diet rich in nitrates and/or salts (e.g., dried, preserved food) - Alcohol and nicotine use- Low socioeconomic status- Atrophic ...
Celiac disease- Bimodal distribution: At 8-12 months and at 30-40 years- Genetic association to HLA-DQ2 (90-95%) and HLA-DQ8 (5-10%)- Commonly associated with autoimmune diseases Etiology: Consuming gliadin from grains ...
Carcinoid tumorSmall, slow-growing neuroendocrine tumors. Bimodal distribution: 15–25 years and 65–75 years (but can occur at any age) Location: GI tract, especially in the intestines (55%), bronchopulmonary organ ...
AppendicitisLifetime risk: ∼8%Peak incidence: 10-19 years of age Etiology: Obstruction of appendiceal lumen by- Lymphoid tissue hyperplasia- Fecalith- Less common: foreign bodies, worm infestations, intestinal ...
Gastroesophageal reflux diseaseChronic condition in which retrograde flow of stomach contents into the esophagus causes irritation to the epithelial lining. Prevalence: ∼15–30% in the US (increases with age) Risk factors/associations:- ...
Peptic ulcer disease- >6 million cases annually in the US- Duodenal ulcers are 3 times more common than gastric ulcers Etiology:- Duodenal ulcers: up to 90% are due to H. pylori infection- Gastric ulcers: up to 80% are ...
Whipple diseaseInfection with the bacteria Tropheryma whipplei. - Very rare, mainly males 30-60 years of age Clinical features:- Malabsorption syndrome, abdominal pain- Enteropathic arthritis (60% of cases), sacroiliitis ...
Stomach histologyCardia:- Epithelium: transition of mucosal epithelium from squamous to columnar epithelium (intestinal) Fundus and body:- Epithelium: rugae with shallow pits and deep glands- Contains mucus cells, gastric ...
Diverticular disease- Common in Western countries and industrialized societies (∼50% of people > 60 years affected) Etiology:- Genetic factors- Diet (low-fiber, rich in fat and red meat)- Obesity, low physical activity- ...