Pathology: Colorectal Carcinoma

Question 1

what is a polyp?

Answer 1

a protrusion above an epithelial surface

Question 2

is a polyp benign or malignant?

Answer 2

can be either

Question 3

name four possible differentials diagnosis of a colonic polyp

Answer 3

adenoma
serrated polyp
polypoid carcinoma
adenocarcinoma

Question 4

name the three types of appearance a polyp can have

Answer 4

pedunculated
sessile
flat

Question 5

is adenoma of the colon benign or malignant?

Answer 5

benign

Question 6

what are most colonic polyps?

Answer 6

adenomas

Question 7

what are all adenomas?

Answer 7

dysplastic

Question 8

why do all adenomas need to be removed?

Answer 8

they are all premalignany

Question 9

what two methods can be used to remove adenomas?

Answer 9

endoscopically

surgically

Question 10

what is the most common primary treatment for colonic adenocarcinoma?

Answer 10

surgery

Question 11

what can adenocarcinoma of the colon cause?

Answer 11

ulceration
stricture
perforation

Question 12

what staging system is used to stage colorectal carcinoma and predict prognosis?

Answer 12

dukes staging

Question 13

describe a colorectal carcinoma with dukes stage A

Answer 13

confined by the muscularis propria

Question 14

describe a colorectal carcinoma with dukes stage B

Answer 14

invaded through the muscularis propria

Question 15

describe a colorectal carcinoma with dukes stage C

Answer 15

has metastasised to lymph nodes

Question 16

which side of the colon is most commonly affected by colorectal carcinoma?

Answer 16

left

Question 17

what parts of the colon are affected in left sided colorectal carcinoma?

Answer 17

rectum
sigmoid colon
descending colon

Question 18

how does left sided colorectal carcinoma present?

Answer 18

blood PR
altered bowel habit
obstruction

Question 19

what parts of the colon are affected in right sided colorectal carcinoma?

Answer 19

caecum

ascending colon

Question 20

how does right sided colorectal carcinoma present?

Answer 20

anaemia and weight loss

Question 21

what three methods of spread can colorectal carcinoma use?

Answer 21

local invasion
lymphatic spread
haematogenous

Question 22

where can colorectal carcinoma spread via local invasion?

Answer 22

the peritoneum and mesentery

Question 23

where can colorectal carcinoma spread via lymphatic spread?

Answer 23

mesenteric lymph nodes

Question 24

where can colorectal carcinoma spread via the haematogenous route?

Answer 24

the liver and other distant sites

Question 25

name the two inherited colorectal cancer syndromes

Answer 25

hereditary non polyposis coli (HNPCC)

familial adenomatous polyposis (FAP)

Question 26

what is HNPCC?

Answer 26

hereditary non polyposis coli

Question 27

how many polyps are present with HNPCC?

Answer 27

less than 100

Question 28

what method of inheritance is involved with HNPCC?

Answer 28

autosomal dominant

Question 29

what causes HNPCC?

Answer 29

a defect in DNA mismatch repair

Question 30

what genes can the mutation for HNPCC be on?

Answer 30

MLH-1
MSH-2
PMS-1
MSH-6

Question 31

which side is affected by HNPCC?

Answer 31

right side

Question 32

what response does HNPCC trigger?

Answer 32

a crohn’s like inflammatory response

Question 33

what other cancers is HNPCC associated with?

Answer 33

gastric and endometrial carcinoma

Question 34

what is FAP?

Answer 34

familial adenomatous polyposis

Question 35

how many polyps are there in FAP?

Answer 35

more than 100

Question 36

which type of inheritance is involved in FAP?

Answer 36

autosomal dominant

Question 37

what causes FAP?

Answer 37

a defect in tumour suppression

Question 38

where is the mutation for FAP found?

Answer 38

FAP genes

Question 39

what type of cancer does FAP cause?

Answer 39

adenocarcinoma

Question 40

what other tumours is FAP associated with?

Answer 40

desmoid tumours

thyroid carcinoma