2: Colorectal pathology

Question 1

What is a polyp?

Answer 1

Protrusion above epithelial surface

general term for masses found on epithelial surfaces

Question 2

Is a polyp benign or malignant?

Answer 2

You don’t know until you’ve investigated it

Question 3

What is an adenoma?

Answer 3

Benign epithelial tumour of the glands

Question 4

What is an adenocarcinoma?

Answer 4

Malignant epithelial tumour of the glands

Question 5

What are the most common polyps found in the colon?

Answer 5

Adenomas

Question 6

Pendunculated polyps hang off ___ attached to the walls of the colon.

Answer 6

stalks

Question 7

Sessile polyps are hard to distinguish from the epithelium because they’re ___.

Answer 7

flat

Question 8

What process would be seen in the epithelium of a polyp under the microscope?

Answer 8

Dysplasia

Question 9

Are adenomas benign or malignant?

Answer 9

Benign

Question 10

What is procedure is performed on polyps once they are found?

Answer 10

Removal

Question 11

What type of tumour can adenomas progress to if they aren’t removed?

Answer 11

Adenocarcinoma (malignant)

Question 12

Which genes mutate to drive cancer progression?

Answer 12

Tumour suppressor genes

Oncogenes

Question 13

Cancer has a strong ___ basis.

Answer 13

genetic

Question 14

By which two methods are adenomas removed?

Answer 14

Endoscopy

Surgery

Question 15

What is the treatment for adenocarcinoms found in the colorectum?

Answer 15

Surgery to remove tumour

Colon/Rectum removed

Question 16

What can adenocarcinomas cause in the large bowel?

Answer 16

Ulcers

Obstruction (strictures)

Question 17

What process occurs in tumours when they lose their blood supply?

Answer 17

Necrosis

Question 18

Higher stages correlate with poor ___ for the patient.

Answer 18

prognosis

Question 19

What staging system is used for colorectal cancer?

Answer 19

Dukes staging

Question 20

What is a Dukes A tumour?

Answer 20

Tumour which is confined by muscularis externa

Question 21

What is a Dukes B tumour?

Answer 21

Tumour has spread through muscularis externa

Question 22

What is a Dukes C tumour?

Answer 22

Tumour has spread through muscularis externa AND metastasised to lymph node

Question 23

Which symptoms present with left-sided colorectal cancer?

Answer 23

Blood in the stool

Altered bowel habits

Bowel obstruction

Question 24

What symptoms present with right-sided colorectal cancer?

Answer 24

Anaemia

Weight loss

Question 25

Which structures are associated with **left-sided colorectal cancer**?

Answer 25

**Descending colon** **Sigmoid colon** **Rectum**

Question 26

Which structures are associated with **right-sided colorectal cancer**?

Answer 26

**Caecum** **Ascending colon**

Question 27

Why do patients with **right-sided colorectal cancer** experience anaemia and weight loss?

Answer 27

**Bleeding**

Question 28

Where can **colorectal cancer** directly spread?

Answer 28

Abdominal organs Peritoneum

Question 29

Which lymph nodes drain the midgut/hindgut and may allow lymphatic spread of colorectal cancer?

Answer 29

**Superior / inferior mesenteric nodes**

Question 30

Which organ may colorectal cancer spread to via the portal circulation?

Answer 30

**Liver**

Question 31

Colorectal cancer be ___ through generations.

Answer 31

**inherited**

Question 32

Colorectal carcinomas tend to be **autosomal (dominant / recessive)**.

Answer 32

**autosomal dominant**