Pathology GIT SAQ For Training

1. Describe the gross and microscopic morphological patterns of

hepatocellular carcinoma (HCC).
Gross Microscopic

• Solitary: Single mass • Acinar pattern

• Multicentric (Multinodular) • Trabecular pattern
• Diffuse (Massive) • ⁠Solid pattern
• Fibrolamellar HCC

2. Describe the gross and microscopic morphological patterns of

esophageal, gastric, and large intestine carcinomas.
Gross Microscopic

• Polypoid fungating • Adenocarcinoma

• ⁠Malignant ulcer • Mucinous carcinoma
• Diffuse infiltrating mass • Signet ring carcinoma
• Undifferentiated carcinoma

3. Describe the gross and microscopic picture in liver cirrhosis.

Gross Microscopic

• Shrunken in size Loss of normal liver architecture:

• ⁠firm consistency • Regenerating nodules
• ⁠dark brown color in • Fibrous septa around
haemochromatosis regeneration nodules
• greenish color in biliary
cirrhosis
• ⁠nodular surface

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4. Define fulminant hepatitis.
• Clinical hepatic insufficiency due to massive hepatic necrosis that
progress from the onset of symptoms to hepatic encephalopathy within
2-3 week.

5. Enumerate effects & complications of gall stones.

• 70% asymptomatic
• ⁠Chronic cholecystitis
• ⁠Squamous metaplasia & malignancy (3%)
• ⁠Migration: acute cholecystitis, acute intestinal obstruction, acute
hemorrhagic pancreatitis, and cholangitis.

6. Describe the morphology of fulminant hepatitis.

Gross Microscopic

• liver may shrink • ⁠complete destruction of

• ⁠it is transformed into a soft hepatocytes in contagious
red organ covered by a lobules with collapsed
wrinkled large capsule reticulin framework and
• cut section: yellow areas of preserved portal tracts.
necrosis stained with bile with • with little inflammatory
dark red areas of hemorrhage reaction.
• Few lobules show few
peripheral surviving cells.

7. Describe the morphology of chronic hepatitis.

• Preserved lobular architecture
• ⁠Hepatocytes shows: hydropic degeneration, and necro-inflammatory
foci. Fatty changes usually exist with HCV.
• Portal tract: expanded by inflammatory cells mainly lymphocytes &
plasma cells with fibrous thickening. Ductular proliferation.

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8. Enumerate types of liver cirrhosis.
• Laennec's cirrhosis
• Biliary cirrhosis
• Post-hepatic cirrhosis
• Post-necrotic cirrhosis
• Congenital disorder as haemochromatosis
• Circulatory disorder as cardiac cirrhosis

9. List the predisposing factors of carcinoma of the esophagus.

• Spicy food
• Smoking
• Achalasia
• Barret esophagus
• Plummer-Vinson syndrome

10. Enumerate complications of carcinoma of the esophagus.

• Esophageal obstruction
• Hematemesis
• Tracheo-esophageal fistula

11. List the predisposing factors of carcinoma of the stomach.

• Spicy food
• Smoking
• Smoked food
• Adenomatous polyp
• Chronic gastritis
• Chronic peptic ulcer

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12. Enumerate complications of carcinoma of the stomach.
• Hematemesis and melena
• Hypochlorhydria due to mucosal destruction (anemia)
• Pyloric obstruction
• Cachexia

13. Enumerate complications of carcinoma of the large intestine.

• Bleeding per rectum
• Piles
• Intestinal obstruction
• Intestinal perforation producing septic peritonitis
• Fistula between intestinal loops, bladder, vagina...

14. Enumerate complications and effects of liver cirrhosis.

• Portal hypertension
• Pancytopenia
• Ascites
• Hepatocellular failure
• Hepatocellular carcinoma
• Hepatorenal failure

15. Enumerate types of liver cirrhosis.

• Laennec's cirrhosis
• Biliary cirrhosis
• Post-hepatic cirrhosis
• Post-necrotic cirrhosis
• Congenital disorder as haemochromatosis
• Circulatory disorder as cardiac cirrhosis