Path 5 Inflammatory Flashcards
False Diverticula
Doesn’t include muscularis propria
Infected diverticula appearance
Apple core lesion
Inflammatory Bowel Disease
- Chronic, relapsing, unknown etiology
- Risk for adenocarcinoma
Crohns disease (4)
- Transmural granulomatous inflammation
- Skip lesions (cobble stone)
- Ulcerations, fissures, fistulas
- Creeping fat
Crohns - most common site
Ileocecum
Crohns - extraintestinal associations (4)
- Migratory polyarthritis
- Iritis
- Erythema nodosum (skin fat inflamm)
- Primary sclerosing cholangitis
Crohns blood finding
-Anti-saccharomyces Ab
Crohns appearance -Endoscope, barium enema
- Cobblestoning
- String sign
Inflammation - Crohns v Ulcerative colitis
Transmural v Mucosal
Ulcerative colitis
- Only colon
- Same extraintestinal as Crohns
- p-ANCA
Ulcerative Colitis appearance -Endoscope, barium enema
- Pseudopolyps
- Granular, loss of haustrations
Crohns v UC clinical symptoms
-RLQ (no diarrhea) v LLQ (w/bloody diarrhea)
Toxic megacolon
Ulcerative colitis only
Malabsorption
Crohns only
Colonic obstruction
Crohns only
Peutz-Jeghers syndrome
- Arborizing hemartomatous polyps
- Hyperpigmented macules on oral mucosa
- Increased risk of other cancers
Solitary rectal ulcer syndrome
- Inflammatory polyps (prone to ulceration)
- Bleeding, mucus discharge
Juvenile Polyposis syndrome
- Cystically dilated, inflamed hemartomatous polyps
- Children and young adults
Hyperplastic polyps (3)
- Never malignant
- Nodular protrusions
- Crypts with proliferating epithelium
Adenoma
Epithelial dysplasia
Sessile Serrated Adenoma
Features mix between adenoma and hyperplastic polyp
Villous adenoma
Broad base, no stalk
Familial adenomatous polyposis (mutation, dx, tx)
-Hereditary APC mutation
>100 adenomas by 20s, 100% chance adenocarcinoma by 30
-Prophylactic colectomy
Gardners syndrome
FAP syndrome
- Abnormal dentition
- Epidermal cysts
- Desmoid tumors
- Osteomas
- Duodenal & Thyroid cancers
Turcot’s syndrome
FAP syndrome
-CNS gliomas
APC gene chromosome
5
Lynch Syndrome (4)
Hereditary nonpolyposis colorectal cancer
- MSH1 & 2 (mismatch repair gene) mutations
- Microsatellite instability
- Colorectal, endometrial, ovarian cancer
Colonic adenocarcinoma morphology (L/R)
- Distal (left) napkin ring lesions
- Proximal (right) raised lesions
Colonic adenocarcinoma serum marker
CEA (for Tx and recurrence, NOT screening)
Appendix tumor (3)
- Carcinoid, less adenocarcinoma
- Mucocele
- Pseudomyxoma peritonei
Carcinoid tumor histology
- Uniform cells
- Island alignment
Pseudomembranous colitis (3)
- Antibiotic associated
- C. Difficile toxins A & B (Dx in stools)
- Volcanic mucopurulent eruptions
Necrotizing enterocolitis (3)
- Premature babies
- Cytokine induced necrotic inflammation
- Pneumatosis Intestinalis (gas cysts in wall)
