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Case 8: GIT diarrhoea > Anat Path: Colonic & Anal Tumours > Flashcards

Anat Path: Colonic & Anal Tumours Flashcards

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1
Q

What is a polyp

A

Rounded mucosal protrusion above adjacent mucosa

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2
Q

What is the 2 types of morphology of polyps

A
  1. Pedunculated: stalk & thin base
  2. Sessile: no stalk & broad base
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3
Q

What is the 3 manner of classifying polyps

A
  1. Layers
  2. Cancerous or not
  3. Morphology
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4
Q

What is the 3 types of non-neoplastic polyps

A
  1. Inflammatory
  2. Hamartomatous
  3. Hyperplastic
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5
Q

Where does inflammatory polyps appear

A

Left side & distal (rectum & descending colon)

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6
Q

What is the appearance of inflammatory polyps

A

Polyploid
Dense stromal inflammation
Surface ulceration
Granulation tissue

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7
Q

What is a hamartomatous polyp

A

Tumour like growth of tissue that is normally present at site

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8
Q

Name a type of hamartomatous polyp

A

Peutz-Jeghers syndrome

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9
Q

What is Peutz-Jeghers syndrome

A

An autosomal dominant disease that causes GI hamartomatous polyps & mucocutaenous hyperpigmentation

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10
Q

What does Peutz-Jeghers syndrome look like

A

Tree like/aborising appearance

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11
Q

What is the complications of Peutz-Jeghers syndrome

A

Obstructions & blockages

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12
Q

Where is hyperplastic polyps mostly found

A

Left side in older people

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13
Q

What is hyperplastic polyps

A

Increase in amount of goblet & absorption cells due to decrease in turnover & delayed shedding

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14
Q

What is a neoplastic polyp

A

It has the potential to become an invasive adenocarcinoma

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15
Q

What is the classification of dysplastic epithelium

A

Low grade & high grade dysplasia

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16
Q

What is the sub classification of neoplastic polyps

A
  1. Tubular: low grade dysplasia
  2. Tubulovillous
  3. Villous: high grade dysplasia
17
Q

What is familial adenomatous polypodies syndrome

A

An autosomal dominants disease w/ multiple adenomas due to mutation in APC gene

18
Q

What is the prophylactic treatment for FAPS

A

Colectomy that prevents colorectal cancer but remains at risk for other cancers

19
Q

What is 4 extra-intestinal manifestations of FAPS

A

Fibromatosis
Osteomas
Thyroid malignancies
Medulloblastomas

20
Q

What is the Knudsen’s 2 hit hypothesis

A

Hit 1: born w/ one defective copy of a gene
Hit 2: damage to remaining functional copy of gene due to mutation in colonic epithelium

21
Q

What is the most common colorectal carcinoma

A

Adenocarcinoma in males 60-70 years

22
Q

What is 3 risk factors for colorectal carcinoma

A

Diet low in fibre & high in fat
Adenoma
Hereditary risk (FAPS & lynch syndrome)

23
Q

What is clinical presentation of right sided colonic adenocarcinoma

A

Fatigue & weakness due to iron deficiency anaemia
Dark black blood
Later appearance due to larger lumen diameter

24
Q

What is clinical presentation of left sided colonic adenocarcinoma

A

Bleeding, changes in bowel habits
Fresh blood
Early clinical presentation due to smaller lumen diameter

25
Q

What is the 3 macroscopic appearance of colorectal carcinoma

A

Polypoid
Annular & constricting
Ulceration

26
Q

What is the 4 local complications of colorectal carcinoma

A

Haemorrhage
Bowel obstruction & stricture
Perforation
Fistula

27
Q

What is the distal complications of colorectal carcinoma & how does it happen

A

Metastases to lymph nodes or haematogenous

28
Q

What type of malignancy is common in anal neoplasia

A

Squamous epithelium carcinoma

29
Q

What is the cause of anal neoplasia

A

HPV that causes warts

30
Q

What is the classification of dysplastic/pre-neoplastic anal lesions

A

Anal intra-epithelial neoplasia:
AIN 1: low grade
AIN 2: intermediate grade
AIN 3: high grade

31
Q

What is the clinical presentation of anal carcinoma

A

Anal bleeding
Anal pain
Pruritis

32
Q

What is the 3 risk factors of anal carcinoma

A

HPV
Crohn’s disease
Smoking

33
Q

What is the areas of local spread of anal carcinoma

A

Perineum & rectum

34
Q

What is the mechanism of spread of metastases of anal carcinoma

A

Regional lymph nodes & haematogenous

Case 8: GIT diarrhoea (11 decks)

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