Neoplasia II: Colonic (Gupta/Jackson) Flashcards
What type of polyp is this?
What type of polyp is this?
What disease?
Peutz Jegher Syndrome
Would this be more likely to be Tubulovillis Adenoma or Tubular Adenoma or Villus Adenoma?
While its really not possible to tell, Villus Adenomas are more likely to be multiple and sessile than the other two
What is shown here?
Apple core lesion causes by mass surrounding the outer colon (CANCER)
Is this appearance more consistent with FAP or Lynch Syndrome?
• why?
While there are several polyps there are not HUNDREDS like it typically seen in FAP
• SHOWN HERE IS LYNCH SYNDROME
What disease is shown here?
FAP - associated with loss of function in APC (B-catenin free to translocated to nucleus)
•These patients form a ton of benign polyps that collectively have a high malignant potential
Is the lesion here more associated with FAP or Lynch Syndrome?
• what is lesion?
Lesion: Adenoma at the Ampulla of Vater => feature of FAP (from APC mutation on chromosome 5)
What type of polyp is likely seen here?
• Key features?
• DDX?
This could be a HYPERPLASTIC POLYP or a Sessile Serrated Adenoma
• Main thing you want to look for is depth of gland hyperplasia and lateral growth - these features would be more suggestive of SSA
What type of polyp is seen here?
• Key features?
• DDx?
Serrated Appearance extends to full depth, there is crypt dilation, and lateral growth this indicates that it is a Sessile Serrated Adenoma and not a hyperplastic polyp
**RIGHT sided location would also be more indicative of SSA
**Shown below is another picture of SSA
What type of colonic polyp is this tissue indicative of?
• What is likely its gross appearance?
• Key histological features?
Key Features:
• Aborizing Network of Smooth Muscle, lamina Propria, and Glands lined with NL epithelium
Grossly this will appear as a LARGE Pedunculated polyp
What feature is key in distiguishing Peutz Jegher Polyps from juvenile polyps that may occur around the same age?
The presence of Smooth Muscle in the tissue
What are the key features of the polyp shown here?
• what type of polyp is it?
Juvenile Polyp
Key Features:
• Cystic Dilation
• Crypts filled with Mucin and Inflammatory Debris
• Expaned Lamina Propria from mixed inflammatory infiltrates
**Shown below is another picture of the Juvenile Polyp***
Differentiate the 3 types of adenomas shown here .
• key histological features.
• Gross Features
Left: Small and Pedunculated with Rounded Tubular Glands (and hyperchromasia)
Middle: Mixed Tubular and Villus elements
RIght: Larger Sessile typically with Long Slender Villi
Key features in this tissue taken from a polypoid lesion in the colon?
What is this?
Mucinous Tumor (possible variant of adenocarcinoma that can be seen)
What is the arrow pointing to?
Signet Ring Cell
How can the appearance seen here help to differentiate from Lung Adenocarcinoma if this lesion were to appear in the lung?
Dirty necrosis consisting of cellular debris + Neutrophils => Only associated with adenocarcinoma from the colon
Differentiate the T1, T2, and T3 in the staging of gastric adenocarcinoma.
