Pathology of colon cancer Flashcards
1
Q
What are the majority of malignant intestinal tumours?
A
Adenocarcinomas
2
Q
Name 5 colorectal epithelial tumours
A
- Adenocarcinoma
- Neuroendocrine neoplasms
- Squamous cell carcinoma
- Metastatic carcinoma
- Adenosquamous carcinoma
3
Q
Explain the adenoma to carcinoma sequence
A
•Normal mucosa - APC/ beta cadherin mutation •Aberrant crypt focus (clusters of abnormal tube-like glands in the lining of the colon and rectum) - KRAS mutation •Early adenoma •Late adenoma •Invasive cancer
4
Q
What are the risk factors of colorectal carcinoma?
A
- Adenoma
- History of IBD
- Increasing age
- Obesity
- Sedentary life style
- High fat/low fibre diet
- Smoking and alcohol use
- Family history e.g. polyposis syndromes
5
Q
What is familial adenomatous polyposis syndrome associated with?
A
APC gene
6
Q
What is Lynch syndrome associated with?
A
Mismatch repair defects
7
Q
What is the definition of a polyp?
A
Exophytic protuberant growth
8
Q
Name four different types of colorectal polyps
A
- Hamartomatous polyps (abnormal collection of mature tissue)
- Inflammatory polyps (ulcerative colitis)
- Hyperplastic polyps (serrated pathway, mismatch repair defects)
- Adenomas
9
Q
What is the variation in the architecture of adenomas?
A
- villous
- Tubulovillous
- Tubular
10
Q
Describe the TNM staging o colorectal carcinoma
A
- T1- invasion into submucoa
- T2- invasion into but not through the muscularis propria
- T3- invasion through the muscularis propria, into sub serosa or non-peritonealised pericolonic/perirectal tissue
- T4- invasion of visceral peritoneum (t4a) and/or other organs (T4b)
- N0 = no regional lymph node involvement, N1= 1-3 regional LN mets, N2= 4+
- M0 = no distant mets
- M1 = distant mets
11
Q
How can we improve earlier detection of bowel cancer?
A
- qFIT testing - bowel screening programme
* Patient education of symptoms i.e. PR bleeding and change in bowel habit, unexplained weight loss
