Polyps

Question 1

Sessile serrated polyps

Answer 1

increase risk of cancer via different oncogenic pathway

Question 2

Types of epithelial polyps

Answer 2

1) Neoplastic
- Adenoma
2) Non-neoplastic
- Inflammatory
- Hyperplastic
- Hamartomas

Question 3

Types of submucosal polyps

Answer 3

GIST
Lipoma
Carcinoid

Question 4

Familial syndromes associated with hamartomatous polyps

Answer 4

Peutz-Jegher
Juvenile polyposis
Cowden’s syndrome

Question 5

Malignant potential of polyps

1) villous adenoma
2) tubulovillous adenoma
3) tubular adenoma

Answer 5

1) 35-40%
2) 20-25%
3) <5%

Question 6

Haggitt classification
Level 0
Level 1
Level 2
Level 3
Level 4

Answer 6

Level 0: no breach of mucosa, intramucosal
Level 1: breach of mucosa, at head of polyp
Level 2: neck of polyp
Level 3: stalk of polyp
Level 4: invading submucosa of bowel wall

Question 7

Kudos classification
Type I
Type II
Type III-L
Type III-s
Type IV
Type V

Answer 7

I: normal
II: hyperplastic
III-L: tubular adenoma (HGD)
III-s: tubular adenoma (LGD)
IV: TVA
V: endoscopically irresectable cancer

Question 8

Kikuchi classification 
Percentage of lymph node metastasis for each category
Sm1
Sm2
Sm3

Answer 8

Sm1 : 1-3%
Sm2: 10%
Sm3: 25%

Question 9

Indications for surgical resection after polypectomy of malignant polyp

Answer 9

Resection margin <2mm
Lymphovascular permeation
Poor differentiation
Haggitt 4 lesion or sessile 
Incomplete resection or inability to assess margin

Question 10

Familial adenomatous polyposis

Answer 10

germline pathological variants in APC
autosomal dominant
> 100 adenomatous polyps

Question 11

Extracolonic manifestations in FAP

Answer 11

Gastric polyps
Duodenal adenoma
Desmoid tumors
Papillary thyroid carcinoma
Hepatoblastoma
Brain tumors

Question 12

List the hereditary colorectal polyposis syndromes

Answer 12

FAP
Hyperplastic polyposis
Peutz-Jeghers
Juvenile polyposis coli
PTEN tumor-hamartoma syndromes
Cowden