Polyposis syndromes

Question 1

What type of colon polyp is this?

Answer 1

Hamartomatous polyp

Smooth muscle runs through the polyp

Question 2

What type of colon polyp is this?

Answer 2

Juvenile polyp
cystic dilations of the crypts
edema and inflammation
1-2 solitary polyps= no malignant risk
>2 polyps = juvenile polyposis syndrome associated with colon and upper GI cancers

Question 3

Answer 3

hyperplastic polyp

Question 4

Answer 4

hyperplastic polyp

Question 5

Answer 5

SSA
serrated crypts
flask shape neck of crypt is smaller than base of the crypt

Question 6

Answer 6

SSA

Question 7

Surveillance recommendations

Answer 7

Question 8

Surveillance recommendations

Answer 8

Question 9

Surveillance recommendations for subsequent exams

Answer 9

Question 10

Answer 10

Traditional serrated polyp

KRAS/BRAF pathway

Question 11

Answer 11

colon adenocarcinoma

Question 12

Answer 12

Tubular adenoma on the right side of the slide
large and dark nuclei

Question 13

Answer 13

tubulovillous adenoma

Question 14

Spiegelman surveillance recommendations

Answer 14

Question 15

Surveillance program for FAP, AFAP, and MutYH

Answer 15

Question 16

Screening program for peuttz jagers syndrome

Answer 16

Question 17

screening program for cowden

Answer 17

Question 18

screening program for hereditary pancreatic cancer and gastric cancer

Answer 18

Question 19

what are the polyp –> carcinoma pathways?

Answer 19

Question 20

Name inheritance pattern and gene mutation
FAP
MAP
Peutz-Jeghers syndrome
Juvenille polyposis syndrome
Cowden syndrome

Answer 20

FAP- AD, APC
MAP- AR, MutYH
Peutz-Jeghers syndrome- AD, STK 11
Juvenille polyposis syndrome -AD, SMAD4, BMPR1A
Cowden syndrome- PTEN

Question 21

Screening program for lynch syndrome

Answer 21

Question 22

IC testing in cancers to r/o lynch syndrome

Answer 22

Question 23

28yo M with painless rectal bleeding. When should he have surveillance colon?

Answer 23

Juvenile polyp
1-2 isolated polyps ok; doest not need to be under surveillance program.
3 -4 polyps is unclear
>5 meets criteria for juvenille polyposis syndrome

cystic architecture with mucus filled glands

Question 24

Answer 24

Sigmoid volvulus

IV abx, endoscopic decompression followed by surgery to pexy the bowel in place

Question 25

Answer 25

SSA

dilated and boot shaped crypts

Question 26

Answer 26

SSA with dysplasia (on the right)