17-8 -- Polyps and Adenocarcinoma Flashcards
Polyps that are small elevations of mucosa WITHOUT a stalk?
Sessile
Polyps that have a stalk?
Pedunculated
Hamartomatous polyps increased ____ risk
Cancer risk increases
2 types of Hamartomatous polyps?
Juvenile polyps
Peutz - Jeghers Syndrome
Juvenile polyps can be sporadic or syndromic. At what age do they usually present?
Less than 5 years old
Sporadic Juvenile polyps
Single polyp
Syndromic Juvenile polyps
3 - hundreds of polyps
With Juvenile polyps, what location is the most common?
Rectum = rectal bleeding
What genes are mutated with syndromic Juvenile Polyps?
SMAD4
BMPR1A
What other congenital malformation may be seen with Juvenile Polyps?
Digital clubbing
Peutz - Jeghers Syndrome occurs between what ages?
10-15
What gene is mutated with Peutz - Jeghers Syndrome?
STK11
What is present with Peutz - Jeghers Syndrome?
Multiple hamartomatous polyps
Buccal mucosal hyperpigmentation
What is present with Peutz - Jeghers Syndrome?
Multiple hamatomatous polyps
Buccal mucosal hyperpigmentation
Peutz - Jeghers Syndrome is at risk for?
Many different malignancies
What gene is mutated with Familial Adenomatous Polyposis (FAP)?
APC gene
With FAP, there are hundreds - thousands polyps. What do those polyps look like?
Sporadic Adenomas
At what age do those colorectal Adenomas present with FAP?
Teenager
What else can be seen with FAP?
Congenital hypertrophy of retinal pigment epithelium
Congenital hypertrophy of retinal pigment epithelium can be seen with?
FAP
The ___ of polyps correlates with risk of malignancy
SIZE
Colonic Adenomas are neoplastic polyps. What do they usually turn into?
Colonic Adenocarcinomas
What is the most common malignancy of the GI tract?
Adenocarcinoma
What diet changes increase risk for colonic adenocarcinomas?
Low fiber
High carbs/fat
What common medications may lower the risk of colonic adenocarcinomas due to the (-) of COX2?
ASA/NSAIDs
What 2 genetic pathways give rise to colonic adenocarcinomas?
APC/Beta catenin/WNT pathway
MSI (microsatellite instability) pathway
FAP is inherited?
Autosomal Dominant
What adenoma and what adenocarcinoma present with FAP?
Tubular Villous Adenoma
– Typical Adenocarcinoma
What is impaired with MYH - associated adenocarcinoma?
DNA mismatch repair
What gene is mutated with MYH - associated adenocarcinoma?
MYH
What adenoma and what adenocarcinoma present with MYH - associated adenocarcinoma?
Sessile, serrated adenoma
– Mucinous adenocarcinoma
What is impaired with Hereditary Non-polyposis colorectal cancer?
DNA mismatch repair
What genes are mutated with Hereditary Non-polyposis colorectal cancer?
MSH2 and MLH1
Hereditary Non-polyposis colorectal cancer commonly affects what side?
Right side
ascending colon
Hereditary Non-polyposis colorectal cancer is also known as?
Lynch Syndrome
What adenoma and what adenocarcinoma present with Hereditary Non-polyposis colorectal cancer?
Sessile, serrated adenoma
– Mucinous adenocarcinoma
What gene/pathway is usually mutated with Sporadic colon cancer?
APC gene/ WNT pathway
Sporadic colon cancer usually affects what side?
Left side
What adenoma and what adenocarcinoma present with sporadic colorectal cancer?
Tubular, villous adenoma
Typical adenocarcinoma
Proximal colon tumors usually are ____ that extend along 1 wall
Exophytic masses
Do Proximal colon tumors cause obstruction?
NO
Distal colon tumors are ____ lesions that produce “napkin ring” constrictions
Annular lesions
Do Distal colon tumors cause obstruction?
YES - annular napkin ring constrictions
Proximal and Distal colon tumors both grow into?
Into bowel
Right side colon tumor symptom?
Iron deficient anemia
Left side colon tumor symptom?
Bleeding and changes in bowel habits
