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GI Pathology > Colorectal Cancer > Flashcards

Colorectal Cancer Flashcards

1
Q

What BV supplies the first 2/3 of Colon?

A

Superior Mesenteric artery

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2
Q

What BV supplies the last 1/3 of colon?

A

Inferior Mesenteric Arteral

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3
Q

What are the 4 layers of the colon wall?

A

Mucosa
Submucosa
Muscularis Propria
Serosa

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4
Q

What is the most lethal cancer?

A

Lung Cancer

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5
Q

How common is colorectal cancer?

A

3rd most common cancer.

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6
Q

Most common cancer?

A

Prostate/Breast

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7
Q

2nd most common cancer?

A

Lung cancer

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8
Q

What are the 4 Genetic Palyers in colon cancer?

A

APC tumor suppressor
K-RAS proto onco-gene
DCC tumor suppressor
p53 tumor suppressor

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9
Q

What are the steps of the Carcinoma sequence?

A

Mucosa ==> Adenoma ==> in situ ==> Invasive Cancer

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10
Q

What is the mutation inherent in FAP?

A

APC gene mutation on chromosome 5q

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11
Q

What is the inheritance pattern of FAP?

A

Autosomal Dominant

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12
Q

What is the treatment for FAP?

A

Total Colectomy

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13
Q

What is the genetic defect in Hereditary Nonpolyposis colon cancer? (lynch syndrome)

A

Mismatch repair gene

Hundreds of polyps, accellerated progression

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14
Q

Treatment for HNCC/Lynch syndrome.

A

Colectomy

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15
Q

HNCC is also associated with…………………… cancer.

A

Endometrial and ovarian cancers.

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16
Q

What are the symptoms of polyps?

A

Asymptomatic. May have positive Fecal Occult Blood Test when advanced.

17
Q

What is required to prepare for a colonoscopy?

A

Clean out colon

18
Q

What is difference between Flexible sigmoidoscopy and colonoscopy.

A

FS only goes to splenic flexure.

19
Q

What are rhe benefits of doing stool based studies?

A

Stool Guiac and Fecal immunochemical test can diagnose while being less invasive.

20
Q

What are the screening regimens for Colorectal cancer?

A 
Colonoscopy every 10 years
or
Flex Sigmoidoscopy every 5 years 
High sensitivity FOBT every 3 years 
or
High sense FOBT every year.
21
Q

What are the screening reccomendations for colorectal cancer?

A

Avg risk? asymptomatic, no family history of cancer, no personal risk of polyps or cancer

start at 50yo
Repeat every 10 years
repeat sooner is polyps found

22
Q

What are the screening reccomendations for colorectal cancer with a Hx of Cancer?

A

start earlier, repeat more frequently

23
Q

What are the screening reccomendations for colorectal cancer with a Hx IBS(UC or CD)?

A

Colonoscopy 8-10 years after onset, 4 random biopsies every 10 years. repeat Every 1-2 years.

24
Q

What are the screening reccomendations for colorectal cancer with a Hx of Lynch syndrome?

A

Colonoscopy 20-25yo
repeat 1-2 years
endometrial surveilance annually.
Urinalysis annually

25
Q

What are the screening reccomendations for colorectal cancer with a Hx of APC/FAP mutation?

A

Colonoscopy age 10-12 repeat 1-2 years
colectomy once polyps are seen.

Ileorectal/ileo-anal
every 1-2 years

26
Q

Diagnostic tests for Colorectal cancer?

A 
XR Abdomen, CTbdomen/Pelvis
Colonoscopy 
-biopsy and tattoo
Proctoscopy
-biopsy and measure distance from sphincters
CBC/CMP
CEA-serum tumor marker 
CT Chest/abdomen/pelvis
Biopsy of Metastatic lesions 
US or MRI for rectal cancer
27
Q

Tumor Staging of Colorectal Cancer

A 
Tis-intraepithelial
T1- MM into SM
T2- invades MP
T3- invades PCR tissues
T4a Penetrates peritoneum
T4b invades adjacent organs.
28
Q

General staging of Colorectal cancer

A

TNM=
Tumor- invasion Depth of primary tumor
Node Extent of Regional LN
Mets- Presence of Distant Mets

29
Q

Nodal staging of CRC

A

N0 no regional node mets
N1- Mets in 1-3 regional nodes
N2- Mets in 4+ regional noedes
15 nodes need to be examined

30
Q

Mets Staging of CRC

A

MO- no distant mets

M1- Distant Mets

31
Q

Definition of Colectomy

A

Resected colon with associated mesentery

32
Q

Low anterior Resection Definition

A

Rectosigmoid resection ext below peritoneal reflection w/ associated mesorectum

33
Q

Abdominal Perineal Resection definition

A

Anal Sphincters, anal opening, and associated mesorectum.

34
Q

How to decide what Treatment to use for colon cancer?

A

T1, T2, T3 = Surgical resection
T3, T4 = Resections with chemo
N1, N2 = resection with chemo
Liver or lung mets = Resection with Chemo
Mets disease = Chemo
-bleeding, obstruction or perforation = Palliative resection

35
Q

How to decide what Treatment to use for colon cancer?

A

tis, T1 = Transanal excision
T2 Resection
T3, T4, N+ = Neoadjuvant Chemo and Resection

36
Q

What are the ongoing Sureillance guidelines after Tx of Colorectal Cancer?

A

H &P every 3-6mon x 5y
CEA every 3-6mon x 5y
CT C/A/P annually x5 y

GI Pathology (12 decks)

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