GI Pathology IV: Large Intestine Flashcards Preview

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Flashcards in GI Pathology IV: Large Intestine Deck (38):
1

True Diverticulum

Involves all 3 wall layers - Mekcel's

2

False Diverticulum

Only involves the mucosa and submucosa

3

Diverticulitis

Inflammation of the diverticula that can cause pain

4

Hernia

Serosal lined outputting of peritoneum - with loops of intestines trapped within the hernia sac

5

What are the symptoms of ischemic bowel disease?

- Sudden severe abdominal pain
- Bloody diarrhea
- Tenderness
- Shock

6

What is the pathogenesis of ischemic bowel disease?

Caused due to hypoxic injury and is worsened with the reperfusion injury

7

Where is the ischemic bowel disease often the worst?

In water shed areas - furthest from circulation - splenic flexure

8

What is the range of damage seen on the gross findings of ischemic bowel disease?

Can range from mucosal hemorrhage to transmural necrosis of the bowel wall

9

Internal Hemorrhoids

They are above the pectinate line and are NOT painful

10

External Hemorrhoids

Below the pectinate line and ARE painful

11

Inflammatory Polyp (Solitary Rectal Ulcer Syndrome)

Sharp angle in the rectum undergoes recurrent abrasion and ulceration that leads to the formation of polyp.

12

What is the histologic pattern seen with an inflammatory polyp?

Fibromuscular hyperplasia in the lamina propria with some inflammation present

13

Juvenile Polyp

Most are found in children younger than 5 yrs and if solitary, then it is benign, if multiple then there is increased risk of adenocarcinoma

14

Peutz-Jeghers Syndrome

Multiple benign hamartomas throughout the GI tract with hyper pigmentation of the lips, genitals and hands.

The polyps do NOT have malignant potential but patients are at increased risk of colorectal cancer.

15

Hyperplastic Polyp

Asymptomatic. Look like adenomas with proliferation of mature goblet cells that pile up on each other giving it a serrated appearance.

16

What are the types of Adenomatous Polyps?

- Sessile
- Pedunculated

17

What is the histology of sessile adenomatous polyps?

Villous

18

What is the histology of pendunculated adenomatous polyps?

Tubular

19

Sessile Serrated Adenoma

Adenomatous polyp occurring predominantly in the right colon and has malignant potential

20

Adenomatous Dysplasia

Neoplastic epithelium which lines the glands leading to disordered cells with or without mucin production and cells have increased N/C ratio

21

What is the gene mutation in Familial Adenomatous Polyposis?

Autosomal dominant defect in APC gene on Ch5q21

22

Gardner Syndrome

Autosomal dominant with polyps similar to FAP but with osteomas

23

Turcots Syndrome

Intestinal adenomas with tumors of the CNS - most have APC mutations

24

Hereditary Nonpolyposis Colorectal Cancer (Lynch Syndrome)

Autosomal dominant mutation of DNA mismatch repair genes that will have a lower number of polyps but with cancer occurring at younger ages than sporadic cancer

25

What is the function of the APC gene?

APC is an inhibitor of B catenin and mutation in APC will cause B catenin to accumulate and active MYC and cyclin D1 leading to the promotion of proliferation

26

What cancers do mutations in the DNA mismatch repair cause?

HNPCC
SSA

27

What cancers do mutations in APC cause?

FAP
Sporadic CRC

28

Right Sided CRC

Asymptomatic for a long period of time with signs of iron deficiency anemia from ulceration and blood loss

29

One what side is the colon larger?

Right

30

Left Sided CRC

The narrower lumen causes tumors that lead to bowel obstruction with possible blood in the stool

31

What is the most common type of rectal cancer?

Adenocarcinoma

32

What is the most common type of anal cancer?

Squamous Cell Carcinoma

33

Acute Appendicitis

Obstruction from fecal matter leads to impair blood flow and bacterial contamination with transmural inflammation that leads to RLQ pain

34

What is seen on histology of appendicitis?

Transmural inflammation full of neutrophils

35

Mucocele

Benign dilatation of the lumen by mutinous secretions

36

Mucinous Cystadenoma

Proliferation of benign neoplastic cells with dilatation of the lumen by mutinous material and it may rupture

37

Mucinous Cystadenocarcinoma

Invasion of neoplastic cells

38

Pseudomyxoma peritonei

Distention of the peritoneal cavity by the presence of semisolid mucin and epithelial mucin producing implants and/or malignant cells

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