Week 7: Colon Cancer Flashcards by William Max Brcko

Q

ID

A

Tubular Adenoma

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Q

ID

A

Sessile Adenoma

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Q

ID

A

Pedunculated Polyp

stalk (blue closed arrow) and polyp (blue open arrow)

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Q

What is the function of the APC protein?

A

binds to and promotes degradation of β-catenin. In excess, β-catenin translocates to the nucleus, activates transcription of genes (MYC [Chromosome 8] and cyclin D-1 [Chromosome 11])

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Q

ID

A

Normal Colon Mucosa

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Q

ID

A

Tubular Adenoma

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Q

ID

A

Mucinous Adenocarcinoma

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Q

ID

A

Epithelial Dysplasia

Elongation of Nuclei (Pencillate) and Nuclear Stratification

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Q

ID

A

Villous Adenoma

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Q

ID

A

Villous Adenoma

finger-like projections of villous (yellow arrows)

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Q

ID

A

Tubulovillous Adenoma

Bad example, just included because its the example in our slides

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Q

ID

A

Tubulovillous Adenoma

Left - Tubular
Right - VIllous

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Q

ID

A

Conventional Invasive Adenocarcinoma

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Q

ID

A

Mucinous Invasive Adenocarcinoma

Desmoplasia – edematous stroma in blue/gray color (yellow arrow)
Associated with Lynch Syndrome

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Q

ID

A

Colonic Adenocarcinoma

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Q

What are two protective factors for the tumor shown here?

A

NSAIDs - COX2 is expressed in these tumors
High fiber, calcium, and vitamin D diet
Decreased consumption of red meat
Decreased or Absence of Alcohol Consumption
Colonscopy with Polyp Removal
Hormone Replacement Therapy (HRT) - post menopasual women only (estrogen is a protective factor)

Colonic Adenocarcinoma

Q

What are the three most important familial syndromes of Adenocarcinoma?

A

Heriditary Nonpolyposis Colon Cancer (HNPCC) / Lynch Syndrome
Familial Adenomatous Polyposis (FAP)
Gardner Syndrome

Q

What is the genetics for Heriditary Nonpolyposis Colon Cancer (HNPCC) / Lynch Syndrome

A

Mismatch Repair Gene / Microsatellite Repeats/Instability

Q

What is the genetics for Familial Adenomatous Polyposis (FAP)

A

APC Gene Mutation / β Catenin Activation

Q

ID

A

Sessile Serrated Adenoma (SSA)

Associated with Lynch Syndrome

Q

ID

A

Invasive Mucinous Adenocarcinoma

Q

What is the genetics for Sessile Serrated Adenoma (SSA) and Mucinous Adenocarcinoma

A

Mismatch Repair Gene / Microsatellite Repeats/Instability

Q

ID

A

Sessile Serrated Adenoma (SSA)

Prominent Dilation of Crypt base in the ID image

Q

ID

A

Sessile Serrated Adenoma (SSA)

Crypt Branching at the base (open blue arrows) and tissue folding in a serrated or jagged pattern the entire length of crypts called the sawtooth appearance (black arrows)

ID

Mucinous Adenocarcinoma

ID

Mucinous Adenocarcinoma ## Footnote Mucin interspacing (yellow ellipses)

ID

Normal MLH1 expression in Immunohistochemistry (IHC) staining

ID

MLH1 mutation in Immunohistochemistry (IHC) staining ## Footnote Lynch Syndrome can result from this mutation

MLH1 mutation in Immunohistochemistry (IHC) staining is usually indicative of what?

Heriditary Nonpolyposis Colon Cancer (HNPCC) / Lynch Syndrome

Where does Heriditary Nonpolyposis Colon Cancer (HNPCC) / Lynch Syndrome usually present in the GI tract?

Right-Sided Colon Carcinoma

Heriditary Nonpolyposis Colon Cancer (HNPCC) / Lynch Syndrome indicates an increased risk of what four carcinomas

* Small Bowel * Ureter * Renal Pelvis * Endometrial/Ovarian ## Footnote SURE

**What 2 conditions are associated with Heriditary Nonpolyposis Colon Cancer (HNPCC) / Lynch Syndrome**

* Sessile Serrated Adenoma (SSA) * Mucinous Adenocarcinoma

ID

Familial Adenomatous Polyposis (FAP)

ID

Familial Adenomatous Polyposis (FAP)

What genes dysfunctioning can result in polyps?

What medications do you treat Colon Adenocarcinoma with?

* 5-Fluorouracil (5-FU) * Oxaloplatin or Irinotecan