Pathology of bowel tumours

Question 1

where are 60% of bowel cancers

Answer 1

sigmoid or rectum

Question 2

what is a benign colonic lesion

Answer 2

adenoma (adenocarcinoma- cancer)

Question 3

what are the types of adenoma

Answer 3

polyp, villous, tubular, tubulovillous

Question 4

what are the 2 types of polyp

Answer 4

sessile and pedunculated (with stalk attached)

Question 5

what features increase likelihood of carcinoma

Answer 5

bigger adenoma, villous, severe dysplasia

Question 6

what staging is used in bowel tumours

Answer 6

Dukes (A,B,C,D)

Question 7

what layers are involved in T1-4

Answer 7

1- submucosa. 2- muscularis propria. 3- subserosa. 4- adjacent structures

Question 8

what is the targeted therapy

Answer 8

cetuximab

Question 9

what is cetuximab an antibody to

Answer 9

EGFR

Question 10

What % of CRC are sporadic and inherited

Answer 10

sporadic- 80%. inherited- 20%

Question 11

what are some of the inherited CRCs

Answer 11

familial adenomatous polyposis; mut-YH associated polyposis; Hereditary non-polyposis CRC

Question 12

what mutation is involved in FAP

Answer 12

APC mutation inherited autosomal dominant.

Question 13

what happens in HNPCC

Answer 13

mutation mismatch repair gene. accelerated adenoma-carcinoma sequence. other tumours-endometrium, stomach, bladder

Question 14

what is the criteria in bowel tumours

Answer 14

Amsterdam criteria

Question 15

what is the Amsterdam criteria

Answer 15

• 3 relatives with CRC or HNPCC related, -cases that span at least 2 generations. - atleast 1 CRC <50 years.

Question 16

what are the features of HNPCC CRC

Answer 16

right sided, poorly differentiated

Question 17

what is Peutz Jeghers syndrome

Answer 17

polyps found throughout the GIT, increase tumous risk

Question 18

what are Juvenile Polyps

Answer 18

> 5 juvenile polyps in colorectum. or juvenile polyps throughout GIT. or any number with a Fhx of juvenile polyposis

Question 19

what is the tumour marker for bowel cancer

Answer 19

CEA