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Pathology > Stomach and Colon CA > Flashcards

Stomach and Colon CA Flashcards

1
Q

Cells that secrete mucus in the Cardia

A

foveolar

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2
Q

Reduces mucin synthesis by inhibiting cox and prostaglandin or reducing bicarbonate

A

NSAID

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3
Q

Neutrophil above basement membrane signifies active inflammation
Intact surface epithelium

Erosion loss of epithelium
Mucosal neutrophilic infiltrate and purulent exudate
Hemorrhage
Layer of necrotic debris, inflamm, granulation, fibrotic scar,

A

Acute gastritis

Acute erosive hemorrhagic gastritis

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4
Q

Affects critically ill shock, sepsis, trauma

Sharply demarcated with normal adjacent mucosa

A

Stress ulcer

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5
Q

Proximal duodenum assoc with severe burns and trauma
Acidosis lowers intracell pH of mucosal cell
Hypoxia and reduced bf by stress vasoconstriction

A

Curling ulcer

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6
Q

Stomach, duodenum, esophagus with intracranial disease
High incidence of perforation
Due to direct stimulation of vagi nuclei causing gastric acid hypersecretion

A

Cushing’s ulcer

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7
Q

Round, less than 1 cm, base stained brown black by acid digested RBCs with transmural inflamm and local serositis

A

Acute peptic ulcer

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8
Q

Most common cause of chronic gastritis is

Antral gastritis
Pit abscess

A

Infection with bacillis H pylori

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9
Q

Most common cause of atrophic gastritis
Less than 10% of cases
Most common form of chronic gastritis without H pylori infection

Typically spares the antrum and includes hypergastrinemia
Characterized by:
antibodies to parietal cells and intrinsic factor
vitamin B12 deficiency
defective gastric acid secretion (achlorhydria)

A

Autoimmune gastritis

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10
Q

Manifests as predominantly antral gastritis with high acid production despite hypogastrinemia
Inc risk of ulcer but gastritis limited to antrum

Antral gastritis
Pit abscess

Lymphoid aggregates with germinal centers and abundant subepithelial plasma cells

A

H pylori associated gastritis

MALT lymphoma

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11
Q

H pylori virulence

A

Flagella - for motility
Urease - for ammonia elevating local gastric pH around organism and protecting bacteria from acidic pH of stomach
Adhesins - enhance bacterial adherence to foveolar cells
Toxins - by cytotoxin associated gene A (CagA) in ulcer or cancer

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12
Q

Chronic antral H pylori may progress to

A

pangastritis resulting in multifocal atrophic gastritis

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13
Q

H pylori complications

A 
Atrophic gastritis
Reduced secretion
Intestinal metaplasia
Inc risk of gastric adenoCa
MALT -> lymphoma
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14
Q

H pylori gastritis preferred eval

A

antral biopsy

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15
Q

Less than 10% of gastritis cases

Spares antrum

Induces hypergastrinemia

Autoantibodies to parietal and IF
Reduced serum pepsinogen I level

Antral endocrine cell hyperplasia

Vit B12 deficiency

Defective gastric acid secretion (achlorydia)

A

Autoimmune gastritis

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16
Q

T/F: H pylori is not associated with pernicious anemia.

A

T

bec parietal and chief cell damage is not as severe as autoimmune gastritis

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17
Q 
Diffuse atrophy of parietal oxyntic cell in body and fundus 
Thinned rug folds lost
Parietal and chief cell loss
Lymphocytic, mac and plasma infiltrate
Intestinal metaplasia
A

Autoimmune gastritis

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18
Q 
Neutrophil, subepithelial plasma cell
Inc acid production
Normal to dec gastrin
Hyperplastic inflammatory polyp
Antibody to H pylori
Peptic ulcer, adenoCa, lymphoma
Low socioecon status, poverty
A

H pylori Antrum Gastritis

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19
Q

Lymphocyte mac
Dec acid
Inc gastrin
Neuroendocrine hyperplasia
Autoantibody to parietal cell HKATpase IF
Atrophy, pernicious anemia, adenoCa, carcinoid
Autoimmune thyroiditis, DM, Graves

A

Autoimmune gastritis

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20
Q

PUD is most common in the
Usually solitary less than 0.3cm, shallow but if 0.6 deeper
Round to oval sharply punched out defect
Smooth clean base from peptic digestion

A 
gastric antrum (interface of body and antrum)
first portion of duodenum (4x)
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21
Q

Primary underlying cause of PUD (2) resulting in imbalance of mucosal defense and damaging forces causing chronic gastritis

A

NSAID
H pylori 70% assoc but only 5-10% develop ulcers

Also smoking and corticosteroids

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22
Q

Multiple peptic ulcer in stomach, duodenum, jejunum by uncontrolled gastrin release by tumor

A

Zollinger-Ellison

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23
Q

CRF and hyperparathyroidism predispose to peptic ulcerations because

A

hypercalcemia stimulates gastrin production and inc acid secretion

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24
Q

Multiple ovoid covered by smooth surface
Irregular cystically dilated foveolar gland
Precancerous in situ lesion:l development correlates with size
Significant inc risk in >1.5cm

A

gastric Polyp

Dysplasia

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25
Q 
Sporadic or FAP but benign
inc bec of PPI use from inc gastrin in response to reduced acidity and glandular hyperplasia 
Nausea, vomiting and epigastric pain 
occur in body and fundus 
Multiple cystically dilated glands
A

Fundic gland polyp

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26
Q

10% of all polyps, intestinal columnar
M 3x
Occurs in chronic gastritis with atrophy and intestinal metaplasia
Risk of development of adenocarcinoma is related to size of lesion elevated in >2cm diameter
Carcinoma in 30%
Dysplastic
Most common in

A

Gastric adenoma

antrum

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27
Q

Most common malignancy of stomach 90%
Dyspepsia dysphagia nausea
Weight loss, anorexia, altered bowel habits, anemia, hemorrhage

Common in low socio, multifocal atrophy and intestinal metaplasia

Gastric cardia cancer on rise bec of Barrett

A

Gastric adenoCa

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28
Q

Mutations in gastric ca

A

CHD1 encoding e-cadherin for intracellular adhesion (familal diffuse type)

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29
Q

Key step in development of diffuse gastric cancer

A

E cadherin function loss

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30
Q

FAP patients have inc risk for gastric ca bec of mutation of

A

APC gene

Mutation of b catenin, microsatellite instability

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31
Q

Gastric adenoCa pathogenesis

A

Gene mutation
H pylori bec of chronic gastritis induced IL 1B production and TNF prod
EBV

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32
Q

Lauren classification is according to

A

intestinal

diffuse

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33
Q

Bulky glandular structure similar to esophageal and colonic adenoCa
Broad cohesive front either as exophytic mass and ulceration
Apical mucin vacuoles abundant mucin

Precursor: flat dysplasia and adenoma

A

Intestinal type gastric adenoca

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34
Q

Infiltrative growth pattern
Discohesive cells with large mucin vacuole expanding cytoplasm and pushing nucleus to periphery creating signet ring cell
Evoke desmoplastic reaction stiffening the wall causing diffuse rugal flattening

Mucin lakes

A

Diffuse type gastric adenoca

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35
Q

Rigid thickened wall imparting leather appearance on diffuse gastric ca

Diffuse rugal thickening

A

linitis plastica

Assoc with signet ring

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36
Q

Most powerful prognostic factor for gastric cancer

A

Depth of invasion, extent of nodal and distant metastasis at time of diagnosis

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37
Q

Most common gastric malignancy lymphoma

A

Indolent extranodal marginal zone B cell lymphoma

MALT

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38
Q

Second most common primary lymphoma of gut

A

Diffuse large B cell

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39
Q

Arise from neuroendocrine organs and G cells

40% in SI (ileum) also in tracheobronchial and lungs

Endocrine hyperplasia, chronic atrophic gastritis,

Zollinger-Ellison

Best considered to be well-differentiated neuroendocrine carcinomas - arise from the endocrine cells

Slow growing small polypoid yellow tan lesions with intense desmoplastic reaction islands, trabeculae, glands, sheets of uniform cells scant, pink, granular cytoplasm round oval stippled nucleus

Mitotic marker:

A

Carcinoid

Ki67

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40
Q

High grade neuroendocrine carcinomas display

And most common in

A

Necrosis

Jejunum

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41
Q

Most important prognostic factor for carcinoid is

foregut
midgut
hindgut

A

location

rarely metastasize before
Lig of Treitz

Jejunum and ileum multiple,
aggressive greater depth of local invasion inc size and necrosis mitosis

Appendix and colorectal, benign ocassionaly metastasize

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42
Q

Most common mesenchymal tumor of abdomen half occuring in stomach

A

GIST

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43
Q

75-80%

GIST have oncogenic

A

gain of function mutation of tyrosine kinase c-KIT

8% PDGFRA

Arise and share common stem cell with interstitial cells of Cajal (gut pacemaker)

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44
Q

Solitary, well circumscribed fleshy submucosal mass
Mets to liver
Thin elongated spindle cell
or plumper epitheloid cell

Spindle
Epitheloid

A

GIST

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45
Q

Most useful marker for GIST

A

c-KIT 95%

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46
Q

GIST is less aggressive than those

A

arising fr intestine

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47
Q

GIST tx

A

Imatinib (tk inhibitor)

Also in CML BCR-ABL gene

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48
Q

Reactive lesions assoc with chronic gastritis

Risk of dysplasia correlates with polyp size

A

Inflammatory and

Hyperplastic polyp

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49
Q

Most common etiologic agent for gastric adenocarcinoma

A

H pylori

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50
Q

Most common benign neoplastic (dysplastic) polyp gives rise to adenocarcinoma

A

Adenoma

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51
Q

Non neoplastic polyp

A

Inflammatory
Hamartomatous
Hyperplastic

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52
Q

Polyp of solitary rectal ulcer syndrome
Rectal bleeding
Mucus dc
Inflammatory lesion of ANTERIOR rectal wall
Impaired relaxation of anorectal sphincter creating sharp angle at rectal shelf
Recurrent abrasion, ulceration of rectal mucosa
Polypoid mass of inflammed and reactive tissue

A

Inflammatory polyp

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53
Q

Sporadic or syndromic
Disorganized tumor growths of mature cell
Rare

Mosy common type:

Children <5
Located in rectum
Rectal bleed, prolapse

Juvenile polyposis assoc with inc risk

A

Hamartomatous polyp

Juvenile polyp

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54
Q

Pedunculated smooth reddish less than 3 cm with cystic spaces
Dilated glands filled with mucin and inflammatory debris
Mucosal hyperplasia, mutation in pathways that regulate cell growth such as TGF B with AD polyposis

A

Hamartomatous polyp

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55
Q

Rare AD with multiple GI hamartomatous polyp and mucocutaneous hyperpigmentation inc risk of malig
Colon, pancreas, breast, lung, ovary etc
Intestinal polyp in SI, large pedunculated with lobulated contour
Arborizing network of CT smooth ms lamina prop and glands by normal epi

A

Peutz Jeghers syndrome

56
Q

Peutz Jeghers is assoc with heterozygous loss of function mutation in gene

A

LKB1/STK11

57
Q

Dec epithelial cell turnover, delayed shedding of surface epithelial cell leading to pileup of goblet cell
No malignant potential
Most common on LEFT COLON
Less than 5cm, smooth, nodular, protrusion of mucosa on crests of mucosal fold
Multiple in sigmoid and rectum with mature goblet and absroptive cell
Delayed shedding leading to crowding creating serrated surface that is morphologic hallmark of these lesions

A

Hyperplastic polyps

58
Q

Screening for colon adenoCa

A

All adults in US undergo colonoscopy starting age 50

If with family hx, screen at least 10 years before youngest age at which relativr was dx

59
Q

0.3-10cm, pedunculated, sessile with surface resembling velvet or raspberry
Epithelial dysplasia with nuclear hyperchromasia, elongation, stratification at surface
Epithelium fails to mature as cells migrate out of crypt
Pedunculated have slender fibromuscular stalk with prominent blood vessel from submucosa
Stalk covered by non neoplastic epi

A

adenoma of colon

60
Q

Adenoma types

A

Tubular - small, pedunculated, small rounded tubular gland
Tubulovillous
Villous - large, sessile slender

61
Q

Most common on the RIGHT colon
Have malignant potential
Overlap features with hyperplastic but lacking dysplasia
Serrated architecture throughout full length of glands and CRYPT involvement (vs hyperplastic)

A

sessile serrated adenoma

62
Q

Most important characteristic correlating with risk of malignancy

A

Size

40% larger than 4cm contain foci of cancer
High grade dysplasia in individual polyp

63
Q

AD, appearance of numerous colorectal adenoma by teenage year

A count of at least 100 necessary

Morphologically indistinguishable from sporadic adenoma

A

Familial Adenomatous Polyp

64
Q

FAP is associated with mutations of

Colorectal CA in 100% before 30 if untreated

Tx

A

APC gene

Prophylactic colectomy
At risk for extraintestinal manif ex neoplasia at other site

65
Q

APC FAP variant

A

Garnder

Turcot

66
Q 
Osteoma
FAP
Epidermal cyst
Desmoid and thyroid tumor
Dental abnormality
A

Gardner

67
Q

Intestinal adenoma FAP
Medulloblastoma/CNS
Glioblastoma

A

Turcot syndrome

68
Q

FAP without APC loss have mutation base excision on repair gene

A

MUTYH

69
Q

Familial clustering of cancer
Colon Ca: younger and affects RIGHT colon
Result from mismatch repair and microsatellite instability

A

Hereditary Nonpolyposis Colorectal Cancer
HNPCC
Lynch syndrome

70
Q

HNPCC involves mutation of

A

MSH2

MLH1

71
Q

Most common malignancy of GI tract

A

Adenocarcinoma

72
Q

Cause polyp regression in patients with FAP whom rectum was in place after cole

A

NSAID

inhibits COX2 in 90%

73
Q

Events that lead to colon adenocarcinoma formation

A

1 APC/Beta catenin pathway - classic adenoma sequence

2 Microsatellite instability pathway

74
Q

80% of sporadic colon tumors
Mutation in APC both must be inactivated
Key negative regulator of beta catenin a component of WNT signalling pathway
Beta catenin accum due to inh of APC MYC and cyclin D1 activation promoting prolif
KRAS mutation
TP53 mutation

A

APC/Beta catenin pathway

75
Q

DNA mismatch repair deficiency
Silent, type II TGFB and Bax
BRAF mutation
MHL1

A

Microsatellite instability

76
Q

Polypoid exophytic extending along wall of large caliber cecum
Rarely cause obstruction

A

Tumors in proximal colon

77
Q

Annular producing napkin ring constrictions and luminal narrowing

A

Distal colon ca

Tall columnar dysplastic epithelium
Strong stromal desmoplastic response - firm consistency
Mucin producing - poor prognosis

78
Q

IDA
fatigue
weakness

A

Cecal

Right sided colon ca

79
Q

Occult bleeding
Changes in bowel habits
Cramping

A

Left sided colorectal adenocarcinoma

80
Q

Two most important prognostic factors in colon ca

A

Depth of invasion
Presence/absence of lymph node metastases

Invasion to muscularis prop dec survival

81
Q

Most common site of metastasis bec of portal drainage

A

liver

82
Q

APC/WNT pathway
Target: APC
Autosomal dominant
Tubular, villous, typical adenoCa

A

FAP 70%

83
Q 
DNA mismatch repair
Target: MUTYH
None or autosomal recessive
Sessile serated adenoma
Mucinous adenoma
A

FAP <10%

84
Q 
DNA mismatch repair
Target: MSH2, MLH1
Autosomal dominant
Right sided
Sessile serated adenoma, mucinous adenoCa
A

Hereditary Nonpolyposis

Lynch syndrome

85
Q 
APC/WNT
Target: APC
No transmission
Left sided
Tubular, villous, typical adenoCa
A

Sporadic colon ca 80%

86
Q 
DNA mismatch repair
MSH2, MLH1
No transmission
Right sided
Sessile, serrated adenoma
Mucinous adenoCa
A

Sporadic colon ca 10-15%

87
Q 
Germline or
Somatic: APC at 5q21 (first hit)
Methylation abn: APC/beta catenin
Proto-onco mu: KRAS at 12p12
Homozygous loss of cancer supressor: p53, LOH and SMAD2 and 4 
Overexpression of COX
additional mutations
gross alteration
A

APC/Beta-catenin pathway

88
Q

Germline or somatic: MLH1 MSH2 MSH6 PMS1 PMS2
Alteration of 2nd allele by LOH, mutation or methylation
Microsatellite instability mutator phenotype
Accumulated mutations: TGFBRII, BAX, BRAF, TCF4, IGFR2

A

Microsatellite instability

89
Q

Lifetime risk for appendicitis

A

7%

90
Q

Progressive inc in intraluminal pressure with compromised venous outflow
50-80% asso with overt luminal obstruction by fecalith
Ischemic injury, stasis, bacterial inflamm
Dull granular appearing erythematous surface
Mucosal neutrophil and focal superficial ulceration
Neutrophilic infiltration of muscularis propria -dx
Focal abscess in wall progressing into hemorrhagic ulcer and gangrene
rupture and suppurative peritonitis

A

Acute appendicitis

91
Q

Most common tumor of appendix

A

Carcinoid at distal tip

92
Q

Acute appendicitis clinically may also present like

A

Appendiceal carcinoma

93
Q

LKB/STK I
Mean age 10-15 years
Arborizing polyp on small intestine > colon > stomach
Mucocutaenous pigmentation
Thyroid, breast, lung, pancreatic and gonadal cancer

A

Peutz-Jeghers syndrome

94
Q 
SMAD4/BMPRI A
Mean age <5
Juvenile polyp inc risk of gastric, si, colon and pancreatic adenoCa
Pulmonary AVM
Digital clubbing
A

Juvenile polyposis

95
Q

PTEN
Hamartomatous polyp, lipoma, ganglioneuroma, inflamm polyp, inc risk of colon ca
Benign skin tumors, benign and malignant thyroid, breast lesion
Mean age of presentation: <15

A

Cowden syndrome

Bannayan-Ruvalcaba-Riley

96
Q

Nonhereditary
Mean age: >50
Hamartomatous colon polyps,crypt dilation, edema in nonpolypoid mucosa
Nail atrophy, hair loss, abnormal skin, cachexia, anemia

A

Cronkhite-Canada syndrome

97
Q

TSC1,TSC2
Mean age: Infancy to adulthood
Hamartomatous polyp (rectal)
Facial angiofibroma, cortical tuber, renal angiomyolipoma

A

Tuberous sclerosis

98
Q 
Osteoma
Desmoida
Skin cyst
APC, MUTYH 
10-15 years
A

Gardner syndrome

99
Q

CNS tumor
Medulloblastoma
APC, MUTYH
10-15 years

A

Turcot syndrome

100
Q

Occurs when closure of the abdominal musculature is incomplete
Abdominal viscera herniate into a ventral membranous SAC

A

Omphalocoele

101
Q

Congenital malformation of abdominal wall (ventral wall)
Defect of the right umbilical cord insertion
All layers of the abdominal wall (from peritoneum to skin)

A

Gastroschisis

Laparoschisis

102
Q

Macroglossia
Ear lobe creases
Omphalocoele

A

Beckwidth Wiedemann Syndrome

103
Q

Most common malignancies associated with Beckwidth Wiedemann Syndrome

A

Nephroblastoma/Wilm’s

Hepatoblastoma

104
Q

Occurs as a result of failed involution of the vitelline duct which connects the lumen of the developing gut to the yolk sac

2% of the population
Within 2 feet 85 cm of the ileocecal valve
Approximately 2 inches 5 cm long
2x as common in males as in females
Symptomatic by age 2
2 Ectopic tissues: Gastric and Pancreatic tissue
2 Complications: Bleeding and perforation

A

Meckel’s diverticulum

105
Q

2% of the population
Within 2 feet 85 cm of the ileocecal valve
Approximately 2 inches 5 cm long
2x as common in males as in females
Symptomatic by age 2
2 Ectopic tissues: Gastric and Pancreatic tissue
2 Complications: Bleeding and perforation

A

Meckel’s diverticulum

106
Q

Most often associated with H pylori-induced hyperchlorhydric chronic gastritis

Most common in gastric antrum and first portion of duodenum (duodenal bulb)

A

Peptic ulcer disease

107
Q

Four times more common in proximal duodenum than stomach
Duodenal ulcers usually occur near pyloric valve (duodenal bulb)

Involve anterior duodenal wall

A

Peptic ulcer disease

108
Q

Sharply punched-out defects
Mucosal defect with clean edges
Necrotic ulcer base composed of granulation tissue indicate

A

benigness

109
Q

Heaped-up ulcer margins

A

Malignancy

110
Q

EXCESSIVE Transforming growth factor alpha (TGF-a)
30-60 y/o
DIFFUSE Hyperplasia of foveolar epithelium of BODY AND FUNDUS
PROTEIN LOSING ENTEROPATHY -> HYPOPROTEINEMIA
Weight loss and diarrhea

A

Menetrier Disease

111
Q

50 y/o
Gastrin secreting tumor called Gastrinoma
Most commonly in small intestine and pancreas
Hyperplasia of parietal cells (5x increase)
Gastrin -> increase mucin production and neuroendocrine cells
Symptoms of peptic ulcer: duodenal ulcer
Not associated with adenocarcinoma instead neuroendocrine carcinoma

A

Zollinger-Ellison Syndrome

112
Q

Stiffening of gastric walls

A

Desmoplastic reaction

Gastric adenocarcinoma

113
Q

Metastases to supraclavicular sentinel lymph node

Metastases to periumbilical region

Metastases to bilateral ovaries
Signet ring cells

Palpable nodules in the pelvic cul-de-sac

A

Late signs of Gastric CA Metastases

Virchow node

Sister Mary Joseph Nodule

Krukenberg tumor

Blumer’s shelf

114
Q

Mucosa-associated lymphoid tissue (MALT) or MALTomas

Most common site of extranodal lymphomas: GI tract (stomach)

BMT/organ transplant recipients

A

Gastric lymphoma

115
Q

The most frequent site for EBV-positive B-cell lymphomas

A

The bowel

116
Q

Young females
Includes gastric GIST, paraganglioma and pulmonary chondroma

Most useful marker is c-KIT

A

Carney triad

GIST

117
Q

Acute compromise of any major vessel can lead to intestinal infarction

Mucosal infarction: muscularis mucosa
Mural infarction: mucosa and submucosa
Transmural infarction: all three wall layers

A

Ischemic bowel disease

118
Q

Most common cause of ischemic bowel disease

A

Atherosclerosis

Other:
aortic aneurysm
hypercoagulable states
OCP use
embolization of cardiac vegetation
119
Q 
Due to acute arterial obstruction
Splenic flexure is the site at greatest risk (Griffith’s point)
Rectosigmoid junction (Sudeck’s point)
A

Transmural infarction

120
Q

Characterized by malformed submucosal and mucosal blood vessels
Cecum or right colon
After the sixth decade of life
Accounts for 20% of major episodes of lower intestinal bleeding

A

Angiodysplasia

121
Q

Also known as celiac sprue or gluten-sensitive enteropathy
Immune-mediated enteropathy triggered by the ingestion of gluten-containing cereals (wheat, rye or barley)
Dermatitis herpetiformis
Characteristic itchy, blistering skin lesion

A

Celiac disease

122
Q

Most common bacterial enteric pathogen
Associated with ingestion of improperly cooked chicken
Associated with Guillain-Barre syndrome

Serum antibodies to C. jejuni lipopolysaccharide cross-react with gangliosides

A

Campylobacter enterocolitis

123
Q

Enteric fever
Caused by salmonella typhi or paratyphi
Gallbladder colonization may be associated with chronic carrier state
Enlargement of Peyer’s patches
Neutrophilic infiltration of lamina propria

A

Tyhpoid fever

124
Q

Caused by Clostridium difficile

Also known as antibiotic-associated colitis or antibiotic-associated diarrhea

A

Pseudomembranous colitis

125
Q

Adherent layer of inflammatory cells and debris

A

Pseudomembranes

126
Q

Denuded surface epithelium

Mucopurulent exudate forms an eruption reminiscent of a volcano

A

Pseudomembranous colitis

127
Q

Caused by the gram-positive actinomycete named Tropheryma whippelii
Malabsorptive diarrea due to impaired lymphatic transport

A

Whipple’s disease

128
Q

Diarrhea
Weight loss
Malabsorption

A

Whipple’s disease

129
Q

In small intestinal lamina propria

Contain PAS positive, diastase-resistant granules

A

Distended foamy macrophages

Whipple’s disease

130
Q

May involve any area of the GI tract

Typically transmural

A

Crohn’s disease

131
Q

Severe ulcerating inflammatory disease that is limited to the colon and rectum
Extends only into the mucosa and submucosa

A

Ulcerative colitis

132
Q

Most common sites involved at presentation are the terminal ileum, ileocecal valve and cecum

Characterized by skip lesions

Clinical presentation
-bloody diarrhea, fever, rectal abscess, small intestinal and colonic ulcers, fistulae

A

Crohn’s disease

133
Q

Earliest Crohn diseaeclesion

Multiple lesions often coalesce into elongated, serpentine ulcers

A

Apthous ulcer

134
Q

Sparing of interspersed mucosa a result of patchy distribution

A

Cobblestone appearance

Crohn’s disease

135
Q

Limited to the colon and rectum
Common extra-intestinal manifestations
Migratory polyarthritis, ankylosing spondylitis
Uveitis, skin lesions
Pericholangitis, primary sclerosing cholangitis
Associated with increased risk of colon CA

Extent of involvement:
Pancolitis: entire colon
Backwash ileitis: mild mucosal inflammation of the distal ileum

A

Ulcerative colitis

136
Q

Acquired pseudo-diverticular outpouchings of the colonic mucosa and submucosa

Most common in the sigmoid colon

Diverticulae are generally multiple and referred to as diverticulosis

A

Sigmoid diverticulitis

137
Q

Increased luminal pressure due to exaggerated peristaltic contractions, with spasmodic sequestration of bowel

Small, flask-like outpouchings - alongside taeniae coli

Epiploic appendices - masses of surrounding fat

A

Sigmoid diverticulitis

Pathology (24 decks)

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