wk 4 2 - colorectal pathology Flashcards
most common pathology of colorectal
carcinoma
polyps
protrusion above epithelial surface
(covers all growths)
mushroom like structure, benign/malignant
which are malignant polyps
polypoid adenocarcinomas
carcinoid polyps
(mesenchymal ones are extremely rare)
most common polyp
benign neoplastic adenoma (dysplastic)
another name for metaplastic polyps
surrated polyps
difference in appearance of flat and sessile polyps
sessile - slightly curved
characteristics of adenoma of colon
benign
not invase, do not metastasise
if left, may turn into adenocarcinoma
tubular, tubullovillous, villous adenomas are all
dysplastic
p53 gene is described as
gatekeeper
everything goes out of control
t/f to progress into a large andeoma, requires mutatio ni np53
false (K-ras mutation required)
for it to develop into an invase adenocarcinoma, requires p53 mutation
what to consider in colouring of histolgoy
blue is bad
red is dead
staging of colorecgal carcinoma can be Dukes A,B,C, what is difference
A: confined by muscularis propria
B: through muscularis propria
C: metastatic to lymph
(predicts prognosis)
majority of colorecctal carcinomas are elft sides, (rectum,sigmoid,descending) what woul be expected
Obstruction
altered bowel habit (constipation/diarrhoea)
blood pr
if it is right sided colorectal carcinoma, what would be expected
anaemia
weight loss
alarm system of colorectal carcinomas
days of constipation
sudden diarrhoea
(lumen comrpessed to slit - builds up ober days then shot out)
how can carcinomas kill u
local invasion (mesorectum, peritoneum/other organs) lymph spread (mesenteric nodes) haematogenous (liver,distant sites)
heriditary non polyposis coli (HNPCC) (Lynch syndrome) and famiial adenomatous polyposis (FAP) are 2 inherited colorectal cancers. What is the difference in each
HNPCC - <100 polyps (50/60yrs)
FAP - >100 polyps (~16yrs)
t/f FAP is due to mutation in FAP gene
true
which 4 genes could HNPCC be due to
MLH-1
MSH-2,6
PMS-1
HNPCC/FAP - which one is due to mismatch in DNA repair
HNPCC
t/f HNPCC more likely to be right sided tumours
true
qwhich inheritrd carcnoma is assoicated with desmoid tumours and thyroid carcinoma
FAP
t/f FAP w patients will have to recieve a prophylactic hysteroectomy
true