Gi 1203 Pathology Of The Bowel

Front 1

What are the two types of polyps?

Back 1

pedunculated and sessile

Front 2

What does a pedunculated polyp look like?

Back 2

raspberry on a stalk

Front 3

What does a sessile polyp look like?

Back 3

no stalk, arises from mucosal surface

Front 4

How do you remove pedunculated polyps?

Back 4

endoscopically

Front 5

What kind of polyps are hyperplastic?

Back 5

benign

Front 6

What is the etiology of benign polyps?

Back 6

decreased cell turnover of surface cells with normal proliferation of cells in the crypt
normal area of cell division, orderly differentiation
crowding of surface goblet and absorptive cells

Front 7

What are the types of hyperplastic polyps?

Back 7

saw tooth, mucin-poor type, microvesicular

Front 8

Where do you find hyperplastic polyps?

Back 8

rectosigmoid colon

Front 9

What do hyperplastic polyps look like?

Back 9

dysplastic and small

Front 10

What is the prognosis of hyperplastic polyps?

Back 10

no cancer

Front 11

What causes hamartomatous polyps?

Back 11

disorganized developmental overgrowth of mature cells normally in the site where you find them

Front 12

What are the most common polyps in kids?

Back 12

retention polyps

Front 13

What kind of polyp is a juvenile polyp?

Back 13

hamartomatous

Front 14

Why do you get juvenile polyps?

Back 14

sporadicially or as a part of Juvenile Polyposis syndrome

Front 15

What is Juvenile Polyposis?

Back 15

multiple juvenile polyps, can develop adenomatous polyps with development of carcinoma

Front 16

Where do you get Juvenile Polyposis polyps?

Back 16

GI tract including stomach

Front 17

What are the complications of Juvenile Polyposis?

Back 17

intestinal bleeding due to ulceration, pulmonary AV malformations, carcinoma

Front 18

What do juvenile polyps look like grossly?

Back 18

up to 3cm, most commonly in the rectum

Front 19

What do juvenile polyps look like histologically?

Back 19

scant smooth muscle fibers, increased inflammation in lamina propria
cystic glandular spaces

Front 20

What is the prognosis of a juvenile polyp?

Back 20

no increased risk of malignancy with single polyp and no adenomatous part

Front 21

What is a Peutz-Jeghers polyp?

Back 21

part of AD clinical syndrome

Front 22

What is the Peutz-Jeghers Syndrome?

Back 22

melanin pigmentation of the lips and buccal mucosa, webs of fingers and toes, hamartomatous polyps in GI tract

Front 23

Where do you find Peutz-Jeghers polyps?

Back 23

small and large intestine

Front 24

What mutation causes Peutz-Jeghers syndrome?

Back 24

LKB1/STK11 gene on choromosome 19

Front 25

What do Peutz-Jeghers polyps look like grossly?

Back 25

2-3 cm in diameter, normally differentiated cells in that area of the gut

Front 26

What do Peutz-Jeghers polyps look like microscopically?

Back 26

arborizing network of smooth muscle and connective tissue in the lamina propria surrounding numerous mucin-secreting glands

Front 27

What is the prognosis of Peutz-Jeghers polyps?

Back 27

uncertain, could have a higher incidence of malignancies elsewhere, but not from the polyp
can cause intussception by large pedunculated polyp

Front 28

What is Cowden syndrome?

Back 28

autosomoal dominant, hamartomatous polyps develop in the intestine, facial trichilemmal tumors, acral keratoses, oral papillomas

Front 29

What is the mutation in Cowden syndrome?

Back 29

PTEN tumor suppressor gene on chromosome 10

Front 30

What is the prognosis of Cowden syndrome?

Back 30

increased incidence of thyroid, uterine, breast cancers

Front 31

What is Ruvalcaba-Riley Syndrome?

Back 31

clinical features with Cowden syndrome, associated with mental and developmental deficiencies

Front 32

What is Cronkite-Canada Syndrome?

Back 32

non-hereditary, hamartomatous polyps in GI tract, nail atrophy, skin pigmentation, alopecia

Front 33

Why do you get inflammatory pseudopolyps?

Back 33

long-standing inflammatory bowel disease, not true polyps

Front 34

What are the types of hamartomatous polyps?

Back 34

Juvenile, Peutz-Jeghers, Cowden Syndrome, Bannayan Ruvalcaba-Riley Syndrome, Cronkite-Canada Syndrome, Inflammatory pseudospolyps

Front 35

Where do serrated adenomas occur?

Back 35

right side of teh colon

Front 36

What is the traditional serrated adenoma?

Back 36

tubular, resembles hyperplastic polyps, but with more complex atypical glands

Front 37

What are sessile serrated tumors?

Back 37

saw-tooth shaped glands lining full length of flask-like crypts, glandular lining cells are stratified and focally dysplastic
goblet cell immaturity, upper zone and surface mitoses, prominent nucleoli in the nuclei

Front 38

What is the prognosis of serrated adenomas?

Back 38

traditional and sessile serrated can both turn into cancer

Front 39

What are adenomatous polyps?

Back 39

neoplastic outgrowths of mucosa of the GI tract

Front 40

What causes tubular adenomas?

Back 40

abnormal cell proliferation due to mutation in APC gene

Front 41

What do tubular adenomas look like histologically?

Back 41

whole crypt and surface cells of the mucosa can proliferate, atypical cytology
branching neoplastic test-tube shaped glands, crowded, pseudostratified nuclei

Front 42

What is the gross appearance of tubular adenoma?

Back 42

pedunculated or sessile

Front 43

Where is the most common place for tubular adenomas to appear?

Back 43

rectosigmoid colon

Front 44

What do villous adenomas look like grossly?

Back 44

sessile, can be very large

Front 45

What is the etiology of villous adneomas?

Back 45

abnormal cell proliferation
all cells are abnormal, whole crypt and villi can proliferate

Front 46

What do villous adenomas look like histologically?

Back 46

papillary fronds, can have mild to carcinoma dysplasia

Front 47

What are the clinical features of villous adenomas?

Back 47

can have water and electrolyte losses when villous adenomas is sessile and large, can get bleeding

Front 48

What are tubulovillous adenomas?

Back 48

20-50% has villous features

Front 49

What is the order of adenomatous polyps causing cancer?

Back 49

villous adenoma, tubulovillous adenoma, tubulous adenoma

Front 50

At what size is an adenomatous polyp at higher risk?

Back 50

2 cm

Front 51

What causes familial polyposis?

Back 51

autosomal dominant transmission

Front 52

What do familial polyposis polyps look like?

Back 52

look like adenomatous polyps, but looks fuzzy

Front 53

What is the prognosis of familial polyposis?

Back 53

cancer is inevitable

Front 54

What is Gardner's syndrome?

Back 54

soft tissue tumors elsewhere in the body, numerous adenomatous polyps

Front 55

How is Gardner's inherited?

Back 55

autosomal dominant

Front 56

What is the prognosis of Gardner's?

Back 56

going to get cancer!

Front 57

What does Gardner's look like?

Back 57

like familial polyposis

Front 58

What is Turcot's Syndrome?

Back 58

brain tumors plus adenomatous polyps

Front 59

How is Turcot's inherited?

Back 59

autosomal recessive

Front 60

What causes Hereditary Non-Polypsosi Colorectal Carcinoma?

Back 60

defect in DNA mismatch repair genes, accumulation of mutations in the nucleus and microsatellite instability