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MD3002 > lower tract GI tumours > Flashcards

lower tract GI tumours Flashcards

1
Q

where do small intestine adenomas usually occur

A

ampulla of Vater

may become malignant

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2
Q

where in the small intestine do adenocarcinomas usually occur

A

duodenum

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3
Q

what do small intestine adenocarcinomas look like

A

polypoid, exophytic, napkin ring

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4
Q

what are the features of adenocarcinomas of the small intestine

A

may cause intestinal obstruction

cramping, pain, nausea, vomiting, weight loss, obstructive jaundice,

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5
Q

what is a hamartoma

A

a benign lesion resembling a neoplasm. grows as a disorganised mass
abnormal tissue in a normal situation

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6
Q

what types of neoplastic adenomas are found in the colon

A

tubular, villous and tubulvillous

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7
Q

what are hyperplastic polyps

A

nipple like protrusions of the mucosa

no malignant potentional

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8
Q

what are juvenile polyps

A

malformations of the mucosa
inflammation
ulceration
non malignant

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9
Q

what is Peutz-Jeghers polyps

A

autosomal dominant condition
many hamartomatous polyps in digestive tract
increase risk of cancer in other parts of the body
hyperpigementation around the mouth can be used to diagnose

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10
Q

where are adenomas found

A

intraepithelium

tubular adenomas are most common

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11
Q

how do you asses the risk of a precancerous adenoma becoming an invasive colorectal adenocarcinoma

A 
risk is correlated with:
polyp size
sessile more likely than tubular
histology is essential to determine its clinical significance
severity of dysplasia
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12
Q

what do large tubular adenomas look like

A

coarsely lobulated with slender stalks

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13
Q

what constitutes invasive carcinoma

A

invasion into the submucosal stalk of the polyp

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14
Q

describe the morphology of villous adenomas

A

affects older people
commonly in the rectum and sigmoid colon
sessile
velvety or cauliflower like masses projecting above the mucosa
covered by displastic columnar epithelium
invasion may occur directly into the wall of the colon

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15
Q

what are the clinical features of colorectal cancer

A

may be assymptomatic
maybe:
anaemia
occult or visible blood

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16
Q

when is endoscopic removal of a pedunculated adenoma suitable

A

the tumour is superficial
there is no vascular or lymphatic invasion
its is well differentiated

sessile polyps are not suitable for polypectomy

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17
Q

what type of tumour do people with FAP have usually

A

tubular adenomas

18
Q

what is the most common type of colorectal cancer

A

adenocarcinoma

19
Q

what are the risk factors for colorectal cancer

A 
excess calorie intake
low vegetable content
high refined carbs
high red meat
decreased micronutrients
20
Q

where is the most common site of colorectal cancer

A

rectosigmoid colon

followed by the caecum and ascending colon

21
Q

what is the morphology of proximal colon tumours

A

polypoid, exophytic masses
obstruction is uncommon
penetrate the bowel wall as white, firm masses

22
Q

what is the morphology of distal colon tumours

A

annular, encircling lesions
ulcerations
narrowed lumen
bowel wall penetration

23
Q

how might a colorectal cancer be diagnosed

A

barium enema
or colonoscopy

“apple core lesion”

24
Q

what is the histology of colorectal cancers

A

may be differentiated or anaplastic
may produce mucin
stimulates growth of fibrous tissue

25
Q

what are the signs of colorectal cancer

A

fatigue, weakness and anaemia
occult bleeding
changes in bowel habit
cramping discomfort

iron deficiency anaemia in an older male = cancer until proven otherwise

systemic symptoms e.g. weight loss and weakness

26
Q

where might colorectal cancers spread

A

lymph nodes, liver, lung, bones, serosal membranes, peritoneum, brain

27
Q

describe Duke’s staging

A 
– A) confined to the
submucosa or
muscle layer (90+%)
– B) spread through
the muscle layer,
but does not yet
involve the lymph
nodes (70%)
– C) involvinglymph
nodes (35%)
28
Q

what are carcinoid tumours

A

derived from endocrine cells
half of small intestine tumours

tend to be very slow growing

29
Q

how do you determine the malignancy of a carcinoid tumour

A

site of origin
depth of penetration
size of tumour
histological features

30
Q

what is carcinoid syndrome

A

the tumour releases hormones which cause symptoms

flushing of the skin
fast heart rate
SOB
diarrhoea, cramps nausea

31
Q

what are the clinical features of carcinoid tumours

A

do not metastasize if in the appendix or rectum

90% survival rate

32
Q

what is GI lymphoma

A

B-cell lymphoma or T cell lymphoma

33
Q

what is a leiomyosarcoma

A

large intramural masses that fungate and ulcerate into the lumen or abdomen
aggressive and rare
mesenchymal

34
Q

what other mesenchymal tumours can occur

A

lipomas
leiomyomas
leiomyosarcoma

35
Q

what are the three zones of the anal canal

A

the upper (covered with rectal mucosa)
• the middle (partially covered with a transitional mucosa)
• lower (covered by stratified squamous mucosa)

36
Q

what are the most common benign tumour of the anus

A

warts

37
Q

what are some malignant tumours of the anal canal

A

basal cell carcinoma
squamous cell carcinoma
adenocarcinoma
melanoma

38
Q

what is the most common type of malignant small intestine tumour

A

adenocarcinoma and carcinoid

39
Q

what is the most common type of colorectal cancer

A

adencarcinoma

40
Q

what is the most common type of benign small intestine tumour

A

adenoma

41
Q

where do adenocarcinomas of the small intestine occur

A

duodenum - napkin

obstruction

42
Q

what is the risk of developing an adenocarcinoma before 30 if you have FAP

A

100%

MD3002 (56 decks)

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