GIT Prelab 36 y/o female, recurrent epigastric pain with massive hematemesis Hematemesis vomiting of blood blood is typically brownish and frothy Hemoptysis 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 malignant potential, borders are heaped up (meaning there 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 is exposed, 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 on the activity of the ulcer c. Granulation tissue normal process/response of the body to repair injury (in this case[ulcer], there is vascularization and fibrosis) differerent from granuloma: ream of lymphocytes, activated macrophages (epitheloid cells), multinucleated giant cells d. Fibrosis Complications: perforationobstructiono edemao fibrosiso depends on ulcer locationif ulcer is located near an opening (e.g. pyloric opening, ulcer in the antral area), if the ulcer forms an elevated lesion, it may cause obstructionsepsiso if perforated, it could cause peritonitis, causing sepsis rupturehemorrhageo due to exposure of the blood vesselsanemiao due to chronic bleeding45 y/o, male Subject: Patho Lab Topic: GIT Lecturer: Dr. Bautista Date of Lecture: Nov. 10, 2011 Transcriptionist: Pinkyred Pages: 7 S Y 2 0 1 1 2 0 1 2
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@ 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
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
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