Colorectal Pathology - Week 4

Question 1

What is meant by a ‘polyp’?

Answer 1

A polyp is a protrusion above an epithelial surface. Tumour.

Question 2

What are the types of polyps?

Answer 2

Mesenchymal or Epithelial and Benign or Malignant

Question 3

Give an example of a benign epithelial polyp.

Answer 3

Inflammatory adenoma

Question 4

Give an example of a benign mesenchymal polyp.

Answer 4

Lipoma

Question 5

Give an example of a malignant epithelial polyp.

Answer 5

Polypoid adenocarcinomas

Question 6

Give an example of a malignant mesenchymal polyp.

Answer 6

Sarcoma

Question 7

Give the differential diagnoses for a colonic polyp.

Answer 7

Adenoma
Serrated polyp
Polypoid carcinoma
Other

Question 8

How is the type of polyp confirmed?

Answer 8

Histopathology

Question 9

Give 5 macroscopic appearances of polyps.

Answer 9

Pedunculated, Sessile, Flat, Irregular surface, long stalk

Question 10

Most polyps are…

Answer 10

Adenomas

Question 11

Which kind of kind occurs in Adenomas?

Answer 11

Dysplasia

Question 12

Adenoma of the colon may lead to…

Answer 12

Adenocarcinoma

Question 13

Why must all adenomas be removed?

Answer 13

They are all pre-malignant

Question 14

How are adenomas removed?

Answer 14

Either done endoscopically or surgically

Question 15

Primary treatment for adenocarcinoma of the bowel is…

Answer 15

Surgical intervention

Question 16

Which staging system is used in colon adenocarcinoma?

Answer 16

Duke’s staging

Question 17

What is meant by Duke’s Stage A?

Answer 17

Confined by muscularis propria

Question 18

What is meant by Duke’s Stage B?

Answer 18

Through muscularis propria

Question 19

What is meant by Duke’s Stage C?

Answer 19

Metastatic to lymph nodes

Question 20

Why is Duke’s Staging of relevance?

Answer 20

Predicts prognosis

Question 21

Where is colorectal cancer most commonly found?

Answer 21

75% Left sided (rectum, sigmoid, descending)

Question 22

What are common presenting complaints of left-sided colorectal cancer?

Answer 22

Blood PR, Altered bowel habit, Obstruction

Question 23

Where is colorectal cancer least commonly found?

Answer 23

25% Right sided (Caecum, Ascending)

Question 24

Give 2 presenting complaints of right-sided colon cancer.

Answer 24

Anaemia, weight loss

Question 25

Colorectal cancer can locally invade…

Answer 25

Mesorectum, Peritoneum, Other organs

Question 26

Colorectal cancer can spread most commonly to which nodes?

Answer 26

Mesenteric nodes

Question 27

Which organ may colorectal cancer spread to?

Answer 27

Liver, distant sites

Question 28

Give 2 examples of inherited cancer syndromes.

Answer 28

Heriditary Non Polyposis Coli (HNPCC) and Familial
Adenomatous Polyposis (FAP)

Question 29

Explain what is meant by HNPCC.

Answer 29

Late onset colorectal cancer caused by defect in DNA mismatch repair. Autosomal dominant inherited mutation in MLH-1, MSH-2, PMS-1 or MSH-6 genes.

Question 30

Explain what is meant by FAP.

Answer 30

Early onset colorectal cancer caused by defect in tumour suppression. Autosomal dominant inheritance by FAP gene.

Question 31

Which type of tumour is more common in HNPCC?

Answer 31

Mucinous tumours

Question 32

Which type of tumour is more common in FAP?

Answer 32

Adenocarcinoma

Question 33

HNPCC is associated with which other cancers?

Answer 33

Endometrial and gastric

Question 34

FAP is associated with which other cancers?

Answer 34

desmoid tumours and thyroid cancer

Question 35

What is the usual location of HNPCC tumours?

Answer 35

Right side

Question 36

What is the usual location of FAP tumours?

Answer 36

Throughout colon