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Flashcards in GIT: Intestinal Tumors Deck (12)
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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)


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


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


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


name the condition

Peutz Jegher Polyp


describe the image

Peutz Jegher Polyp

arborizing network of smooth muscle between glands


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


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


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


____ is the tumor marker for colon cancers

CEA is the tumor marker for colon cancers


 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


____ 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)