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Old 03-08-2012
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GIT Histologic finding after many years of heartburn!

Heartburn for many years. endoscopy is performed and biopsy taken. Which finding is most likely?

a. exophytic lesion with atypical squamous cell invading the mucosa
b. flat lesion with gland forming structures invading the mucosa
c. lesion consisting of smooth muscle cells with no invasion
d. red velvety mucosa with some cellular atypia but no invasion

ans: B
why not d? and why is there mucosa invasion??
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Old 03-08-2012
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i would think b/c of the acid. reason for heartburn is when the cardiac sphincter gets weak and the acid from the stomach leaks into the esophagus. causing an ulcer at first then the invasion and attack!
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Old 03-08-2012
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Default classic for esophageal adenocarcinoma.

it is esophagitis --> Barett 's esophagus --> adenocarcinoma.
Since many years have passed, its worth concerning that adenocarcinoma is present, hence B is ans.
Red velvety is acute inflamm condition, in chronic inflm condition, you find scar, atrophy and stricture.
Beware, stricture and achalasia is more common than esophageal tumor. So they can ask about achalasia in the context of heart burn also.
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