PATHOLOGY OF THE
GASTROINTESTINAL
TRACT, PART II
VI. practical training
3rd year General Medicine
Haemorrhagic infarction of the intestine
Haemorrhagic infarction of the intestine
Infarction of the intestine
Enteritis cararrhalis acuta
Enteritis cararrhalis acuta
Pseudomembranous colitis
ULCERATIVE COLITIS
Local complications
ULCERATIVE COLITIS
Systemic complications
Ulcerative colitis
Ulcerative colitis
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
Ulcerative colitis – crypt abscess
1
2
3
1 Crypt abscess
2 Inflammatory infiltrate in mucosa
3 Lamina muscularis mucosae
Ulcerative colitis – detail - crypt abscess
1
1 crypt abscess
Ulcerative colitis
Crohn´s disease
Crohn´s disease
Crohn´s disease
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
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
Enteritis regionalis (colon) – Morbus Crohn
1
2
3
4
1 Mucosa
2 Submucosa
3 Muscularis propria
4 Serosa and subserosa
5 Inflammatory infiltrate
5
Enteritis regionalis (colon)– Morbus Crohn
1 Fissure in mucosa
2 Crypts without dysplastic changes
3 Chronic inflammatory infiltrate
1
2
2
3
Morbus Crohn
Diverticular disease
Diverticulitis of the large bowel
Meckel’s diverticulum
Intestinal polyp
Intestinal polyp
Intestinal tubulo-villous adenoma
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
Intestinal polyps
Mesenchymal
Benign
lipoma
hemangioma
fibroma
leiomyoma
Malignant
sarcomas
lymphomas
Appendix-normal
copy
Ulcerophlegmonous appendicitis
copy
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
Ulcerophlegmonous appendicitis
1 Inflammatory exudate in lumen
2 Mucosa with massive inflammation
3 Muscularis propria
1
2
3
Ulcerophlegmonous appendicitis
1 Phlegmonous infiltrate in muscularis
propria
2 Phlegmonous infiltrate in subserous
connective tissue
2
1
Ulcerophlegmonous appendicitis, detail
Carcinoid of the appendix
1 2
1 Carcinoid in apendix
2 Lymphatic tissue in apendix
Carcinoid of the appendix – detail
1
1 2
1 Tumour cells
2 Stroma of tumour
Carcinoid of the appendix – detail
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
Chronic cholecystitis
1 Epithelium
2 Chronic inflammatory infiltration in mucosa
3 Muscularis propria
1
1 2
2
2
3
3
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
Absceding cholangitis
Cystic fibrosis of the pancreas
Cystic fibrosis of the pancreas
Acute haemorrhagic necrosis of pancreas
Colorectal adenocarcinoma
Colorectal adenocarcinoma
Colorectal adenocarcinoma
Top Related