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Gastrointestinal 2 > Pathology of Gastrointestinal Cancers > Flashcards

Pathology of Gastrointestinal Cancers Flashcards

1
Q

What is meant by an adenoma?

A

Benign neoplastic growth e.g a dysplastic polyp in the colon / rectum.

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2
Q

What are the key differences between benign and malignant neoplasms?

A

Malignant neoplams are infiltrating and invasive to tissue and metastasise to other sites.

Benign neoplasms are localised and encapsulated.

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3
Q

Metastisis

A

Secondary deposit of cancer away from the primary cancer.

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4
Q

Dissemination (metastasis) occurs through what 4 processes?

A
  1. Haematogenous spread - venous to liver/lungs.
  2. Lymphatic spread to regional lymph nodes.
  3. Seeding of body cavities e.g peritoneal cavity.
  4. Mechanical spread e.g needle biopsy tract. (Iatrogenic).
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5
Q

Which of well differentiated and poorly differentiated neoplasms have the worse prognosis?

A

Poorly differentiated malignant neoplasms have the worst prognosis.

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6
Q

What microscopic features indicate malignancy?

A
  1. Increased Nuclear:Cytoplasmic ratio as the nucleus enlarges.
  2. Pleomorphism - lot’s of different forms.
  3. Hyperchromatic (dark) nuclei
  4. Mitoses
  5. Loss of polarity - no clear organisation
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7
Q

Carcinoma refers to cancer of the

A

epithelium

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8
Q

Melanoma refers to cancer of the

A

Melanocytes

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9
Q

Sarcoma refers to cancer of the

A

Mesenchymal cells / germ cell tumour

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10
Q

What is the normal epithelial lining of the oesophagus?

A

Squamous epithelium

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11
Q

What type of cancer normally forms in the oesophagus? (excluding barretts)

A

Squamous cell carcinoma

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12
Q

What changes to epithelium occur in Barrett’s oesophagus?

A

Squamous epithelium is replaced by glandular epithelium (columnar metaplasia).

Risk of malignancy - formation of an adenocarcinoma.

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13
Q

Why does metaplasia of squamous to columnar epithelium occur in Barrett’s oesophagus?

A

The squamous epithelium is unable to deal with the acidic conditions resulting from GORD, where as the columnar epithelium can - hence you get metaplasia to columnar epithelium.

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14
Q

Staging of oesophageal dyplasia

A
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15
Q

What epithelium lines the stomach?

A

Simple columnar - glandular epithelium

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16
Q

What are the risk factors of gastric cancer?

A

Smoking

Diet

H.pylori infection

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17
Q

What type of malignancy may be seen in the stomach?

A

Adenocarcinoma

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18
Q

Metaplasia dysplasia carcinoma sequence

A
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19
Q

What are the two main types of gastric adenocarcinoma?

  • what’s the prognosis for each?
A

Intestinal type - low grade, localised growth

Diffuse type - infiltrative - consists of poorly cohesive maligant cells that are invasive.

Signet ring cell carcinoma = diffuse type

20
Q

Signet ring cell carcinoma

A

Signet ring cell carcinoma (SRCC) is a rare form of highly malignant adenocarcinoma that produces mucin.

21
Q

Histology of gastric adenocarcinoma

A
22
Q

Histology of signet ring cell carcinoma

A
23
Q

What are the different types of gastric tumours?

A

Gastric adenocarcinoma

Neuroendocrine tumours

Gastrointestinal stromal tumours

Lymphoma B-cell tumours

24
Q

H.pylori can give you what two types of stomach cancer?

A

Gastric adenocarcinoma

Lymphoma

25
Q

What do gastric neuroendocrine tumours secrete?

A

Gastric neuroendocrine tumours secrete gastrin.

26
Q

What is the histology seen here?

A
27
Q

What cause gastric neuroendocrine tumours to form?

A

Arise in stomach on a background of hypergastrinaemia (atrophic gastritis or gastrin-producing neoplasm) or occur sporadically.

Gastrinoma – duodenum or pancreas.

28
Q

Summary of gastrointestinal stromal tumours.

A
29
Q

What can been seen here?

A
30
Q

What is the most common cause of small bowel tumours?

A

Metastasis

31
Q

What are the different types of small bowel tumours?

A
  • Neuroendocrine tumours most common neoplasm.
  • GISTs
  • Lymphoma
  • Small bowel adenocarcinoma
32
Q

What are the risk factors of small bowel adenocarcinoma?

A

Familial Adenomatous Polyposis (FAP), Crohn’s disease, coeliac disease.

33
Q

What is the most common type of tumour seen in the appendix?

A

Neuroendocrine tumour

34
Q

How is the risk of progression of an adenoma in the colon classified?

A

Risk of progression to invasive adenocarcinoma is related to the number, size, villous architecture, and grade of dysplasia.

Note: average progression from adenoma to adenocarcinoma is around 10 years.

35
Q

Histology of colorectal adenoma’s

Tubular

Villous

Low grade

High grade

A
36
Q

What is being shown here in this histology slide?

A
37
Q

Name the condition shown?

What is the treatment?

A

Familial Adenomatous Polyposis

Treatment is Colectomy

38
Q

How are tumour staged?

A

TNM Classification

T - extent of primary tumour

N - lymph node involvement

M - Distant metastases

39
Q

Tumour Staging (T)

A
40
Q

Lymph Node Staging (N)

A
41
Q

Metastasis staging (M)

A
42
Q

What can be seen in this histology?

A
43
Q

What can be seen in this histology?

A
44
Q

Peutz Jeghers Syndrome

A

Peutz-Jeghers syndrome is characterized by the development of noncancerous growths called hamartomatous polyps in the gastrointestinal tract (particularly the stomach and intestines) and a greatly increased risk of developing certain types of cancer.

45
Q

What does lynch syndrome lead to?

A

Lynch syndrome which is characterised by aggressive right sided colonic malignancy and endometrial cancer is caused by microsatellite instability of DNA repair genes.

Gastrointestinal 2 (24 decks)

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