Colorectal Pathology Flashcards
What is a polyps?
It is a protrusion above an epithelial surface (it is a tumor (remember tumour means swelling, but that does not have to indicate if it is benign or malignant).
What are the differentials for a polyps?
Adenoma.
Serrated polyp.
Polypoid carcinoma.
Other.
What are Adenoma of the colon?
They are benign tumours, they are non-invasive and they do not metastasise. However they should all be removed by surgery or endoscope as they are premalignant.
What are the three different types of polyps that are adenomas?
Tubulovillus.
Tubular.
Villous.
What causes ademoma’s in the colon to become malignant and turn into adenocarinomas?
Genetic mutations cause it too happen.
Describe the staging used for an adenocarcinoma of the colon that predicts the prognosis?
They use Dukes staging
Dukes A - the tumour is confined to the muscularis propria.
Dukes B - The tumour has gone through the muscularis propria but not affected any lymph nodes yet.
Dukes C - Metastatic to the lymph nodes.
You can do TNM staging as well though.
How would a Colorectal carcinoma spread?
Through local invasion.
Lymphatic spread through the mesenteric lymph nodes.
Blood spread through to the liver and lungs.
What are the likely causes of Colorectal cancer?
Environmental factors - red meat, smoking, processed food.
Genetic factors.
Underlying conditions like UC and Crohn’s.
Increasing age is a large factor.
How would you diagnose Colorectal cancer?
CT colography.
Colonoscopy.
How do you treat Colorectal cancer?
Surgery.
Radiotherpay.
Chemotherapy.
What are the two main inherited cancer syndromes for Colorectal cancer?
HNPCC and FAP.
What are the symptoms for someone with Colorectal cancer?
Unexplained weight loss.
Unexplained iron deficiency anaemia.
Persistan tiredness.
Rectal bleeding.
What investigations are done for someone with suspected Colorectal cancer?
Sigmoidoscopy.
CT colonography.
If someone is diagnosed with Colorectal cancer where else might you want to investigate?
A CT of the abdomen to look for liver metastasis. Think about this for all cancers as you would want to investigate where the cancer usually metastasise to.
What are types of surgery that are done in Colorectal cancer?
Open surgery.
Laparoscopic surgery - leaves less scaring than open surgery.
Robotic.
