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42 Cards in this Set
- Front
- Back
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What is the definition of a polyp?
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Protrusions of mucosal elements from the surface of the polyp
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What are the different kinds of polyps?
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Pedunculated: attached by a stalk
Sessile: growing into the wall. |
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What are the different kinds of colon polyps?
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Developmental
Inflammatory (pseudo-polyp) Hyperplatic Neoplastic Normal mucosa Mixed |
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What are the different kinds of neoplastic colon polyps?
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Adenomas
Carcinomas |
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What are the kinds of developmental polyps?
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Juvenile
Hamartomas (Peutz-Jeghers) |
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What kind of a polyp is a juvenile polyp? What's inside it?
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Hamartomas
Excess lamina propria; hardly any muscularis |
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What structures occur inside juvenile polyps?
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Budding
CYstic tubules (crypts or pits) |
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Where are juveinle polyps found?
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COLON > small intestine >> stomach
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What condition do you find lots of juvenile polyps?
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Juveinle polyposis syndrome
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What mutations are found in juveinle polyposis?
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Mutations in SMAD4
Mutations in BMPR1A Deletion of PTEN |
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What cancers are people with a SMAD4 at higher risk for?
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GI
Pancreatic Biliary 80% RISK!!! |
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What is the composition of a peutz-jeghers polyp?
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Branched muscularis mucosae
Hamartomas |
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What mutations are found in Peutz-Jeghers polyps?
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STK11 on 19p
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What cancers are people with Peutz-Jeghers polyps at risk for?
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All cancers; not just GI
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Where are peutz-jeghers polyps found?
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SI >> colon and stomach
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What is a classic finding in Peutz-Jeghers syndrome?
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Oral-perioral pigmented spots
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What is the distribution of the colorectal mucosal polyps?
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Adenomas: 66%
Hyperplatic: 33% Juvenile: 1% |
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What is the definition of a GI adenoma?
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Localized collection of in-situ dysplastic epithelium that isn't post-inflammatory
Can be low or high grade |
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What are the cellular characteristics of adenomas?
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Cell, nuclear crowding
Enlarged, elongated nuclei Increased N:C Less cytoplasmic maturation |
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How do you differentiate between high and low grade adenomas?
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Degree of crowding
Architecture! |
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How do you differentiate between an adenoma and a polyp?
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Adenomas BECOME polyps when enough epithelium accumulates to produce a protrusion
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What are the different kinds of archistecture for tumors?
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Villous
Tubular Tubulovillus |
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What are the characteristics of adenomas that are at risk for a carcinomatous epithelium?
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LARGE
VILLOUS Multiple Carcinoma-associated Flat |
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When does colon cancer metastasis occur?
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When the tumor reaches the lymphatics, which are in the superficial submucosa.
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What is the function of APC? P53? K-RAS?
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APC:Tumor suppressor
p53: Tumor suppressor K-RAS: oncogene |
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What happens in a colonic hyperplastic polyp?
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Overgrowth of regular mucosa due to delayed turnover
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What is the appearance of hyperplastic polyps?
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Serrated architecture
Hypermature |
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Where are colonic serrated polyps found? Who gets them?
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More distal; left colon
Older people get them. |
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Are hyperplastic polyps typically associated with cancers?
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No, not usually
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What are the characteristics of cancerous serrated polyps?
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Large
Right-sided Architecturally complex You see dysmaturation all throughout the polyp rather than just at the top. |
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Who's more at risk for cancer; crohns or UC?
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Ulcerative colitis
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Where in the world do you typically find squamous cell CA of the esophagus?
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Asia
Iran |
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What are risk factors for squamous cell CA of the esophagus?
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Smoking, drinking
HPV |
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What kind of dysplasia do we see in the esophagus in the US?
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Barrett's
Replacement of the squamous epithelium with columnar; precuros to cancer |
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What population gets adenocarcinama in barrett's?
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Chronic GERD
Whit emen |
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What are the types of cancers of the stomach?
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Tubular
Signet ring cell |
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What is the most common cause of gastric cancer?
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H. pylori
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What are some of the types of liver cncer?
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Hepatocellular carcinoma
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What are the risk factors for liver cancer?
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Viral hepatitis
Cirrhosis |
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Where does pancreatic cancer typically occur?
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Head of the pancreas
It's a ductal cancer |
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What stage is pancreatic cancer typically found at? Why?
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High grades
It almost invariably spreads to the lymph nodes. |
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Where do we screen for cancers?
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Colon cancers
People with GERD |
