Week 7: Polyps

Question 1

ID

Answer 1

Polyp

Question 2

What percent of polyps are benign?

Answer 2

95%

Question 3

ID

Answer 3

Hyperplastic Polyp

Serrations (blue circle), tapering at the crypt base (yellow trapezoid), and no dysplasia

Question 4

ID

Answer 4

Inflammatory Polyp

Lymphocytes (yellow arrows) and dilated crypts (cyan arrow)

Question 5

ID

Answer 5

Hamartomatous Polyp

Question 6

ID

Answer 6

Hamartomatous Polyp

Dilated crypts (cyan ellipse), abundant and inflamed stroma (yellow arrow), and surface erosion (orange arrows)

Question 7

What mutation is associated with Juvenile Polyps/Juvenile Polyposis Syndrome?

Answer 7

Autosomal Dominant SMAD4/ BMPR1A mutation

Question 8

ID

Answer 8

Juvenile Polyp

Dilated crypts (cyan circle), abundant and inflamed stroma (yellow arrow), and surface erosion (orange arrow). Essentially a Hamartomatous Polyp, but in a child.

Question 9

An 11-year-old female presented to the emergency department with severe abdominal pain and was found to have intussusception of the small bowel. She was taken for emergent bowel resection. Physical exam had revealed dark blue to brown macules on the lips, nostrils and palmar surfaces of the hands.

Answer 9

Peutz-Jeghers Syndrome (PJS)

Hamartomatous Polyposis with arborizing smooth muscle

Question 10

ID

Answer 10

Peutz-Jeghers Syndrome (PJS)

Broad bands of smooth muscle (yellow arrows). Hamartomatous Polyposis with arborizing smooth muscle

Question 11

ID

Answer 11

Peutz-Jeghers Syndrome (PJS)

Broad bands of smooth muscle (yellow arrows). Hamartomatous Polyposis with arborizing smooth muscle

Question 12

ID

Answer 12

Peutz-Jeghers Syndrome (PJS)

Type of Hamartomatous Polyp. Smooth muscle creates an aborization.

Question 13

ID

Answer 13

Peutz-Jeghers Syndrome (PJS)

Hamartomatous Polyposis with arborizing smooth muscle

Question 14

What mutation is associated with Peutz-Jeghers Syndrome (PJS)?

Answer 14

Loss-of-function in STK11/LKB1 gene

Question 15

What are three manifestations of a PTEN Hamartoma-Tumor Syndrome

dark freckles on the penis in AMAB only

Answer 15

• Macrocephaly
• Telangectasia
• Lipomas

Question 16

What mutation is associated with PTEN Hamartoma-Tumor Syndrome

Answer 16

Phosphate and Tensin homolog deletion

Question 17

ID

Answer 17

Trichillemmoma

Question 18

ID

Answer 18

Lipoma

Question 19

ID

Answer 19

Macrocephaly

Question 20

Hamartomatous polyps of the GI tract, nail atrophy, alopecia, skin hyperpigmentation, diarrhea, cachexia and anemia

Answer 20

Cronkhite-Canada Syndrome

Question 21

ID

Answer 21

Cronkhite-Canada Syndrome

Skin hyperpigmention (left) and nail atrophy (right)

Question 22

ID

Answer 22

Cronkhite-Canada Syndrome

Question 23

ID

Answer 23

Facial Angiofibromas

Tuberous Sclerosis - TSC1 and TSC2 gene

Question 24

ID

Answer 24

Cortical Tubers

Tuberous Sclerosis - TSC1 and TSC2 gene

Question 25

ID

Answer 25

Angiomyolipoma ## Footnote blood vessel (orange arrow), smooth muscle spindles (cyan arrow), and lipomas (yellow arrow)

Question 26

ID

Answer 26

Angiomyolipoma

Question 27

ID

Answer 27

Juvenile Polyp

Question 28

ID

Answer 28

Tubular Adenoma

Question 29

What mutation is associated with Adenomatous Polyposis

Answer 29

Adenomatous Polyposis Coli (APC) gene

Question 30

What medication(s) can cause polyp regression?

Answer 30

* NSAIDs 1. Aspirin 2. Acetaminophen 3. Ibuprofen ## Footnote Effect is mediated by inhibition of the COX-2 enzyme (cyclooxygenase-2) which is highly expressed in colorectal carcinomas and adenomas. Taking NSAIDs prevents colorectal cancer

Question 31

ID the sublayers of the colonic Mucosa

Answer 31