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34 Cards in this Set
- Front
- Back
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what is the most likely layer for neoplais to arise from?
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epithelium, bc it divides most rapidly
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what are the colorectal cancer screening guidlines?
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colonoscopy ever 10 after 50
every 5, felixibel sigmoidoscopy barium enema or ct colongraphy |
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hamartomatous polyps including smooth muschle growth
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peutz jeghers (less common than other types of polyps)
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what is the most common type of polyp in western world?
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neoplastic adenomas
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what type of polyp is most commonly seen in colonoscopy?
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hyperplastic poyps, usually samll left sided asymptomatic
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saw tooth glands star shaped configuration
hypermature epithelium that doesnt shed non neoplastic, but a lot could predispose for malignancies goblet cell rich |
hyperplastic polyps (serrated)
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saw tooth edge star shpaed gland
flask shaped glands inverted growth pattern (mimics malignancy) Pre malignant! larger, ridht sided |
sessile serrated adenoma
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jagged star shaped moprphology
eosinophilic scyotplasm elngoated nuclei rare left sided, villiform |
traditional serrated adenoma
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older female pts
polyps around ampuularry region large tumor: obstruction jaundice ag pain pancreatits |
small bowel adenomatous polyps
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50% of people after age 50 in west
family history and syndromes earlier stong genetic and nutironal factors oftern asymp, but may presen w/ occult bleed or iron defieincy anemia |
large bowel adenomatous polyps
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are all adenomas considered premalignant?
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oh year
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histology of subtypes of adenomatous polyps:
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tubular
villous tubulovillous elongated nuclei loss of polarity increased mitosis |
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hyperchromatic nuclei, rounded cells, loss of polarity, mor mitosis
more inflammaiton and necrosis cribriform growth pattern, invasion of stroma |
high grade dysplastic adenomas
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what are two molecular pathways for genoic insability of adenocarcinomas?
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85% chromosomal insability
(mostly APC/beta catenin path 15% microsatelite instaily: altered size of repetitive DNA sequences and defectiv DNA mismatch repair enzymes |
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what is the adenoma carcinama preogression?
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normal colon--> hit in germilne or tumor suppressor genes (APC or beta catenin)
mucosal has lost one allele for sumre suppp, other tummor supp allele gets hit through methylaiton of promoter -->complete loss of APC upregulaiton or increased mutaiton of proto oncogenes K_RAS adenoma ACCUMULATION OF HITS OVER TIME LEAD TO CARCINOMA AND INVASION |
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what is the microsatelit adenmo carc progresion?
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another tsg gets hit (MLH1 or MSH2)
loss of intial allele followed by lsos of 2nd leads to sessile serrated adenomas and hyperplastic looking polyps more mutations lead to invasive carcinomas |
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whar are some biloglical risk factos/protectors for colorectal carcinoma?
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risk: meat consumption (nitrosamines and heterocyclic compounds) alcohol
protect: veggies, folate, fiber, nsaids hormomen replacement |
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where are colorect adenocarcinomas distributed
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half cecum/ascending
half rectum sigmoid |
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apple core lession
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adenocarcinoma: narrowed lumen, odd bowel habits
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signet ring cell adenocarcinoma
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poorly differentiated; easy to miss bc few cells in biopsy
eccentric nuclei, mucin droplets poor prognosis |
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what is Familial adenomatous polyposis?
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AD germ mutaiton of APC
>100 polyps 100% risk of cancer |
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osteomas
desmoid tumors congenital hypertophy of renial pigme (Gardeners) brain gliomas |
extra intestinal manifestations of FAP
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where does the FAP germ mut occur
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5q21 (apc tummor suppressor)
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what is the most common type of colon cancer (sporadic, genetic, etc.)
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sporadci
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highest and lowest survival rate locations of Neuro endocrin tumors?
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highest: appendix
loswet colon most common: SI |
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flushing, diarrhea, astham, tricuspid regurge
high circulat levels of hormones (serotonin) mestastais to liver |
carcinoid syndrome
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how do you stage NET?
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by mitotic count
morphology doesnt tell you how its going to act |
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middle aged older pts
rarely congenital soft tissue tumor in stomach |
GIST
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what is the cell origin of GIST
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ICC interstitial cels of cajal
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what pathway is GIST related to?
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cKit or platelet derived fowth facter recpeto alspha mutlation (a tyrosine kinase)
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what are GIsT histological subtypes:
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spindle cell morphology
epitheliod morphology |
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arise form lamina propira or muscularis mucosa
spindle cells perinuclear vacuoles |
leiomyomas
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like leiomyoma but more malignant: increase mitosis and necrosis
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leiomyosarcoma
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what is the most common type of hematopoetic neoplasm?
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large B cell lymphoma verry aggressive
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