GI tumors and polyps - STEP and Pathomoa and class

Question 1

What is the difference: Sessile vs. pedunculated polyp

Answer 1

• Sessile will be less of a bump with a stalk
  
  • It’s more of a bump right on the surface
  • Pedunculated is more diverticular and it has a stalk
  • Sessile is more tubular in architecture, while peduncular is more villous

Question 2

What is the difference: Adenoma vs. Adenocarcinoma vs. carcinoma

Answer 2

when it has carcinoma in the name, it’s invasive. Adenoma is pre-cursor to carcinoma. Adenocarcinoma is a glandular tissue tumor (look for the gland hyperplasia)

Question 3

What are the three types of non-neoplastic polyps?

Answer 3

• Inflammatory
	• Hamartomatous
		○ Juvenile
		○ Peutz-heghers
		○ Cowden
		○ Cronkhite-canada
	• hyperplastic

Question 4

What are inflammatory polyps?

Answer 4

• Often present with bleeding
• Often due to mucosal prolapse
○ Especially common in the rectum
• Cycles of injury and healing will result in inflammation, ulceration/erosion, epithelial hyperplasia and POLYP formation

Question 5

What are hamartomatous polyps?

Answer 5

• Most are childhood or pre-pubertal in presentation
• Tumor-like over-growth
○ More tissue, but it’s in the right place.
○ Colonic tissue histologically, growing in the colon, there’s just too much of it
• Think Peutz-Jeghers
• Also worry about syndromic juvenile polyps often having a foci of dysplasia
• Also worry about future risk
○ GI carcinoma so increase screening schedule
○ Extra-GI manifestations
○ Genetic counseling?