Small and Large Bowel III Flashcards
What is the morphology of an inflammatory polyp?
Inflamed and regenerating mucosa that projects above the level of surrounding mucosa which is also ulcerated
What syndromes can cause inflammatory polyps? Where do they occur?
Caused by solitary rectal ulcer syndrome, ulcerative colitis, and crohn’s disease
Occurs anywhere in GI tract
What are the two ways juvenile (retention) polyps can generate?
Sporadically or as a result of polyposis syndrome
When retention polyps arise from polyposis syndrome, what is the individual at an increased risk of developing?
Adenocarcinoma
What is the microscopic morphology of a juvenile retention polyp? Gross morphology?
Microscopic: Multiple dilated, mucin filled crypts.
Gross: Usually rounded, smooth, unilobular with erythematous cap
What is the presentation of Peutz-Jeghers polyps?
In childhood with GI bleed and intussusception
What is mutated in Peutz-Jeghers syndrome?
Tumor suppressor gene STK11
What is the microscopic morphology of PJ polyps?
Hyperpigmentation
Smooth muscle arborizing pattern
What region is common to see lesions in PJS?
Oral
What is the clinical presentation of a hyperplastic polyp?
Single or multiple
Mostly in left colon
No worry of cancer progression
What is the microscopic morphology of hyperplastic polyps?
Serration of midportion of individual glands
If in the small bowel, where do adenomatous polyps most often present?
Duodenum
Where do adenomatous polyps mostly occur?
Colon
What are the two common morphologies for adenomatous polyps?
Sessile (attachment with flat base)
Pedunculated polyp
Where do sessile serrated adenomas most often present?
Right colon
What do sessile serrated adenomas turn into?
Adenocarcinoma
What is the gross appearance of sessile serrated adenomas?
Lacks adenomatous epithelium of regular adenomas
Flat
What is important about crypt morphology in sessile serrated adenomas?
Dilation of crypts
What is the inheritance pattern of FAP?
Autosomal dominant
What is mutated in Lynch syndrome?
MMR
What happens to DNA with MMR mutation?
Accumulation of mutations in microsatellite DNA
What is Gardner’s syndrome?
Desmoid tumors, dental abnormalities, thyroid tumors, osteomas, and epidermal cysts in addition to FAP
What is Turcot syndrome?
Hereditary colon cancer syndrome along with CNS tumors
Which side does MMR tend to show up on?
Right
What is the clinical presentation of left sided tumors?
LLQ disomfort
Occult bleeding
Bowel habit changes
Cramping
What is the clinical presentation of right sided tumors?
Fatigue and weakness due to iron deficiency anemia
What is important about finding out the KRAS mutation?
If KRAS mutaiton, Cetuximab is not as effective
What are risk factors for small bowel adenocarcinoma?
FAP
Crohn’s
Celiac disease
What do nonfunctioning GI tract Neuroendocrine tumors present as?
Vague
Abdominal pain
Nausea, vomiting
Weight loss
What GI cancer can result in Zollinger ellingson syndrome?
Functioning neuroendocrine tumors
What is described as pigmentation of mucosa due to certain laxatives?
Melanosis coli
What can MALT lymphoma turn into?
lymphomatous polyposis
What is the morphological findings for acute appendicitis?
Supperative inflammation with gangrenous necrosis
How does acute pancreatitis present?
Periumbilical pain that localizes to RLQ
What are the best diagnostic tests for acute appendicitis?
Ultrasound and CT
What complications can come from acute appendicitis?
Periappendiceal abscess
Pyelophlebitis
Portal venous thrombosis
Bacteremia, sepsis
