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Flashcards in GIT: Intestinal Tumors Deck (12)
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1

describe juvenile polyp (hamartomatous polyp)

  • aka retention polyp
  • common in children < 5 years but also seen in adults
  • rectum is most common site
  • rarely juvenile polyposis syndrome (AD)
  • sporadic single polyps; NO MALIGNANT POTENTIAL
  • juvenile polyposis syndrome: increased risk of malignancy
  • also seen in Cowden and Bannayan-Ruvacalba-Riley syndromes (PTEN mutations)

2

juvenile polyps most commonly occur in the ____ and there is no chance for ____ unlike _____

juvenile polyps most commonly occur in the rectum and there is no chance for malignancy unlike juvenile polyp syndrome (AD) where there is an increased risk for malignancy

3

describe the structure and histology of a juvenile polyp

usually 1-3 cm, lobulated with stalk

  • histology:
    • expanded lamina propria
    • abundant cystically dilated glands
    • inflammatory cells may be present

4

describe Peutz Jegher polyp (hamartomatous polyp)

  • sporadic or syndromic forms
  • PJ syndrome:
    • AD
    • multiple polyps in whole GIT
    • melanotic pigmentation in mucocutaneous areas, lips, perioral areas, face, genitalia and palms
  • arborizing network of smooth muscle between glands
  • glands are lined by non-dysplastic epithelium rich in goblet cells
  • risk of developing carcinomas of pancreas, breast, lung, ovary and fetus

5

name the condition

Peutz Jegher Polyp

6

describe the image

Peutz Jegher Polyp

arborizing network of smooth muscle between glands

7

the risk of an adenoma becoming malignant increases with... (4 things)

  1. polyp size (most important criteria)
  2. severity of dysplasia
  3. villous architecture
  4. 3 or more adenomasb

8

describe familial adenomatous polyposis (FAP)

  • genetic defect in APC gene (chr. 5)
  • colorectum: small intestine and stomach
  • typically 500-2500 tubular adenomas
  • attenuated FAP: fewer than 100
  • prophylactic total colectomy due to high risk of colorectal cancer
  • Gardner syndrome:
    • tubular adenomas with osteomas, desmoid tumors, epidermal cysts
  • Turcot syndrome
    • tubular adenomas with CNS gliomas

9

describe right-sided vs. left-sided colon cancers

  • right-sided: 
    • fatigue, weakness and iron deficiency anemia (bulky and bleed easily)
  • left-sided
    • altered bowel habits

10

____ is the tumor marker for colon cancers

CEA is the tumor marker for colon cancers

11

 list the 3 settings in which neuroendocrine tumors occur in the stomach (carcinoid)

  • type I: autoimmune gastritis
    • gastric atrophy and achlorhydria
    • hypergastrinemia leads to ECL cell hyperplasia
    • may be multiple, usually follows benign course
  • type II: gastrinoma (Zollinger-Ellison syndrome)
    • usually in MEN 1 syndrome, hypergastrinemia
  • type III: sporadic
    • more aggressive than other types

12

____ is the most common site in the GIT for neuroendocrine tumors

small intestine and appendix is the most common site in the GIT for neuroendocrine tumors

  • can metastasize widely leading to carcinoid syndrome when liver involved
    • wheezing, diarrhea, flushing
    • 5HT elevated (right side of heart: fibrosis)