PATHOLOGY OF THE GASTROINTESTINAL TRACT, PART IIustavpatologie.upol.cz/_data/section-1/173.pdf ·...
Transcript of PATHOLOGY OF THE GASTROINTESTINAL TRACT, PART IIustavpatologie.upol.cz/_data/section-1/173.pdf ·...
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PATHOLOGY OF THE
GASTROINTESTINAL
TRACT, PART II
VI. practical training
3rd year General Medicine
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Haemorrhagic infarction of the intestine
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Haemorrhagic infarction of the intestine
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Infarction of the intestine
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Enteritis cararrhalis acuta
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Enteritis cararrhalis acuta
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Pseudomembranous colitis
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ULCERATIVE COLITIS
Local complications
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ULCERATIVE COLITIS
Systemic complications
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Ulcerative colitis
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Ulcerative colitis
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Ulcerative colitis
1
2
3
4
4
1 Mucosa with parts of preserved epithelium
2 Inflammatory infiltrate in mucosa and
submucosal connective tissue
3 Muscularis propria
4 Ulceration in mucosa
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Ulcerative colitis – crypt abscess
1
2
3
1 Crypt abscess
2 Inflammatory infiltrate in mucosa
3 Lamina muscularis mucosae
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Ulcerative colitis – detail - crypt abscess
1
1 crypt abscess
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Ulcerative colitis
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Crohn´s disease
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Crohn´s disease
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Crohn´s disease
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A comparison of Crohn’s disease and ulcerative
colitis
Grossly
Location
Extension
Lumen narrowing
Wall thickeness
Fistulations
Crohn’s disease
From oral cavity to anus
– right-sited colitis
– mostly small intestine
segmental
typical
typical
common
Ulcerative colitis
Large intestine
– left-sited colitis
– rektum
diffuse
not typical
not typical
absent
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A comparison of Crohn’s disease and ulcerative
colitis
Microscopicaly
Transmural inflammation
Submucosal fibrosis
Fisuration
Granulomas
Crypt abscess
Crohn’s disease
typical
typical
typical
common
not typical
Ulcerative colitis
not typical
absent
sporadic
absent
typical
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Enteritis regionalis (colon) – Morbus Crohn
1
2
3
4
1 Mucosa
2 Submucosa
3 Muscularis propria
4 Serosa and subserosa
5 Inflammatory infiltrate
5
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Enteritis regionalis (colon)– Morbus Crohn
1 Fissure in mucosa
2 Crypts without dysplastic changes
3 Chronic inflammatory infiltrate
1
2
2
3
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Morbus Crohn
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Diverticular disease
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Diverticulitis of the large bowel
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Meckel’s diverticulum
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Intestinal polyp
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Intestinal polyp
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Intestinal tubulo-villous adenoma
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Intestinal polyps
Epithelial
Non-tumorous
Sporadic
adenomas
heredital
familiar
syndromes
Benign
hyperplastic
juvenile
inflammatory
lymphoid
tubular adenoma
villous adenoma
tubulo-villous
FAP
Gardner’s sy (+ osteomas, soft tissue tumours)
Turcot’s sy (+ malignant CNS tumours)
Peutz-Jeghers’ sy
Malignant
polypoid carcinoma
carcinoids
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Intestinal polyps
Mesenchymal
Benign
lipoma
hemangioma
fibroma
leiomyoma
Malignant
sarcomas
lymphomas
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Appendix-normal
copy
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Ulcerophlegmonous appendicitis
copy
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Ulcerophlegmonous appendicitis
1 Inflammatory exudate in lumen
2 Mucosa
3 Muscularis propria
4 Subserous connective tissue
All layers are infiltrated by phlegmonous
infiltrate
1 2 4
3
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Ulcerophlegmonous appendicitis
1 Inflammatory exudate in lumen
2 Mucosa with massive inflammation
3 Muscularis propria
1
2
3
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Ulcerophlegmonous appendicitis
1 Phlegmonous infiltrate in muscularis
propria
2 Phlegmonous infiltrate in subserous
connective tissue
2
1
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Ulcerophlegmonous appendicitis, detail
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Carcinoid of the appendix
1 2
1 Carcinoid in apendix
2 Lymphatic tissue in apendix
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Carcinoid of the appendix – detail
1
1 2
1 Tumour cells
2 Stroma of tumour
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Carcinoid of the appendix – detail
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Chronic cholecystitis
Normal Chronic cholecystitis
1 mucosa 2 muscle layer 3 subserous tissue
1
1
1
1
2
2 2
2
3
3 3
3
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Chronic cholecystitis
1 Epithelium
2 Chronic inflammatory infiltration in mucosa
3 Muscularis propria
1
1 2
2
2
3
3
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Chronic cholecystitis – Aschoff-Rokitansky sinus
1 Epithelium
2 Chronic inflammatory infiltration
in mucosa
3 Muscularis propria
4 Aschoff-Rokitansky sinus
1
1
2
2
3
3 4
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Absceding cholangitis
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Cystic fibrosis of the pancreas
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Cystic fibrosis of the pancreas
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Acute haemorrhagic necrosis of pancreas
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Colorectal adenocarcinoma
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Colorectal adenocarcinoma
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Colorectal adenocarcinoma