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GI > Pathology of the colorectal carcinoma > Flashcards

Pathology of the colorectal carcinoma Flashcards

1
Q

What is a polyp?

A

A protrusion above an epithelial surface, that is a tumour (swelling)

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2
Q

What is the differential diagnosis when a colonic polyp is found?

A

Adenoma
Serrated polyp
Polypoid carcinoma
Other

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3
Q

What are the different macroscopic types of polyp?

A 
Pedunculated
Sessile
Flat 
Irregular surface
Long stalk
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4
Q

What is an adenoma of the colon?

A

Benign tumour, non invasive and does not metastasise

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5
Q

What are most polyps?

A

Adenomas but the architecture is variable - can be tubullovillous, tubular or villous but all are dysplastic

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6
Q

What is the adenoma-carcinoma sequence?

A

Normal mucosa
Adenoma (dysplastic)
Adenocarcinoma (invasive)

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7
Q

Why must all adenomas be removed?

A

They are all pre-malignant

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8
Q

How are adenomas removed?

A

Endoscopically or surgically

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9
Q

How do not all coloerectal adenomas have the same molecular genetic origins?

A

Separate pathways for inherited tumours

Separate pathways for serrated tumours

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10
Q

What is the primary treatment for adenocarcinomas?

A

Primary treatment is surgical

Colon/rectum is removed and sent to pathology for staging

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11
Q

What is the dukes staging for colorectal carcinoma?

A

Dukes A: confined by muscularis propria
Dukes B: Through muscularis propria
Dukes C: Metastatis to lymph nodes

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12
Q

Where are the majority of colorectal carcinomas found?

A

75% left sided (rectum, sigmoid, descinding colon) - blood in rectum, altered bowel habit, obstruction
25% right sided (caecum, ascending) - anaemia and weight loss

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13
Q

How can the gross appearance of colorectal carcinoma differ?

A

Polypoid, stricturing, ulcerating

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14
Q

Where is colorectal cancer likely to spread to locally?

A

Mesorectum, peritoneum, other organs

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15
Q

Where is colorectal carcinoma likley to spread in the lymph system?

A

Mesenteric nodes

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16
Q

Where are colorectal carcinomas likely to spread via the blood?

A

Liver, distant sites

17
Q

What are examples of inherited cancer syndromes?

A

Heriditary Non Polyposis Coli (HNPCC) less than 100 polyps

Familal adenomatous polyposis (FAP) with lgreater than 100 polyps

18
Q

What are the characteristics of HNPCC?

A

Late onset, autosomal dominant, defect in DNA mismatch repair
Inherited mutation in MLH-1, MSH-2, PMS-1 or MSH-6 genes
Right sided, mucionus tumour
Crohn’s like inflammatory response
Associated with gastric and endometrial carcinoma

19
Q

What are the charateristics of FAP?

A 
Early onset
Autosomal dominant
Defect in tumour suppresion 
Inherited mutation in FAP gene 
Throughout colon, adenocarcinoma NOS
No specific inflammatory response 
Associated with desmoid tumours and thyroid carcinoma
20
Q

What are the common diseases of the large bowel?

A

Polpys
Adenomas
Adenocarcionma

GI (42 decks)

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