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Transcript
Morphology Experiment
Pathology of Cardiovascular Disease
Wei Zhang (张伟)
[email protected]
Tel: 13819103401
Morphology Experiment
Pathology of Digestive Disease
Purpose
• Master the classification and morphological features of
Chronic Gastritis.
• Master the morphological features and complications of
Digestive Ulcer.
• Familiar with the classification and morphological features
of Gastric Carcinoma.
• Familiar with the classification and morphological features
of Esophageal Carcinoma.
Contents
1. Slides
2. Specimens
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1 Gastritis
2 Peptic ulcer
3 Appendicitis
4 Carcinoma of esophagus
5 Carcinoma of stomach
6 Carcinoma of large intestine
Anatomy and histology of the stomach
• In ulcers with ongoing necrosis, four zones are demonstrable:
• (1) the base and margins have a superficial thin layer of necrotic fibrinoid
debris not visible to the naked eye; 坏死层
• (2) beneath this layer is a zone of non-specific inflammatory infiltrate, with
neutrophils predominating; 炎症层
• (3) in the deeper layers, especially in the base of the ulcer, there is active
granulation tissue infiltrated with mononuclear leukocytes; 肉牙组织层
• (4) the granulation tissue rests on a more solid fibrous or collagenous scar.
疤痕层
Peptic ulcer of the duodenum
Complications of Peptic Ulcer Disease
1. Bleeding
• Occurs in 15% to 20% of patients
• Most frequent complication
• May be life-threatening
• Accounts for 25% of ulcer deaths
• May be the first indication of an ulcer
2. Perforation
• Occurs in about 5% of patients
• Accounts for two thirds of ulcer deaths
• Rarely, is the first indication of an ulcer
3. Obstruction from edema or scarring
• Occurs in about 2% of patients
• Most often due to pyloric channel ulcers
• May also occur with duodenal ulcers
• Causes incapacitating, crampy abdominal pain
• Rarely, may lead to total obstruction with intractable vomiting
4. Malignant transformation
Intestinal metaplasia
• Refers to the replacement of gastric epithelium with
columnar and goblet cells of intestinal variety.
• Gastric intestinal type carcinomas appear to arise
from dysplasia of this metaplastic epithelium.
Appendicitis
• Acute simple appendicitis
• Acute phlegmonous appendicitis
• Acute gangrenous appendicitis
Acute appendicitis