PATH - Colonic Polyps Flashcards
Hyperplastic Colonic polyps
*Non-neoplastic
Generally smaller and majority located in *rectosigmoid area.
Hamartomatous Colonic polyps
Generally *non-neoplastic
*solitary lesions do not have a significant risk of malignant transformation.
Growths of normal colonic tissue with *distorted architecture.
Associated with *Peutz-Jeghers syndrome and *juvenile polyposis.
Adenomatous Colonic polyps
*Neoplastic, via chromosomal instability pathway with mutations in *APC and KRAS.
Tubular histology has less malignant potential than villous
tubulovillous has intermediate malignant
potential.
Usually asymptomatic; may present with occult bleeding.
Serrated Colonic polyps
- Premalignant, via *CpG hypermethylation phenotype pathway with microsatellite instability and mutations in *BRAF.
- “Saw-tooth” pattern of crypts on biopsy.
Up to 20% of cases of sporadic *CRC.
Familial adenomatous
polyposis (FAP)
*Autosomal dominant
mutation of *APC tumor suppressor gene on *chromosome 5q
- Thousands of polyps arise starting after puberty
- pancolonic
always involves *rectum.
Prophylactic colectomy or else 100% progress to *CRC.
Gardner syndrome
FAP + *osseous and soft tissue tumors, congenital hypertrophy of retinal pigment epithelium,
*impacted/supernumerary teeth
Turcot syndrome
FAP + malignant CNS tumor
“Turcot = Turban”
Peutz-Jeghers syndrome
Autosomal dominant
featuring *numerous hamartomas throughout GI tract, along with *hyperpigmented mouth, lips, hands, genitalia.
Associated with INC risk of breast and GI cancers (colorectal, stomach, small bowel, pancreatic)
Juvenile polyposis syndrome
Autosomal dominant
syndrome in children (typically
Lynch syndrome
Autosomal dominant
AKA hereditary nonpolyposis colorectal cancer (HNPCC)
mutation of *DNA mismatch repair genes with subsequent microsatellite instability
*Proximal colon is always involved
∼ 80% progress to *CRC
Associated with endometrial, ovarian, and skin cancers
