Lower GI Neoplasia (Quiz 2) Flashcards

(36 cards)

1
Q

what is the most common of malignant small bowel tumors

A
  • carcinoid
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2
Q

what is a carcinoid tumor

A
  • rare, well-differentiated neuroendocrine tumor
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3
Q

most common location for carcinoid tumor

A
  • ileum
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4
Q

symptoms if a carcinoid tumors obstructs the bowel

A
  • desmoplasia - growth of fibrous or connective tissue

- intussusception

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5
Q

what is carcinoid syndrome

A
  • metastasis of carcinoid tumor to the liver
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6
Q

symptoms of carcinoid syndrome

A
  • flushing
  • diaphoresis
  • diarrhea
  • wheezing
  • hypotension
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7
Q

appendices carcinoids usually occur where

A
  • tip of appendix
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8
Q

histology of carcinoid syndrome

A
  • bland tumor cells
  • salt and pepper chromatin
  • no large nucleoli
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9
Q

distinguishing factor of carcinoid tumor cells

A
  • synaptophysin positive (stains red)
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10
Q

what polyps have no malignant potential and no increased risk for CRC

A
  • hyperplastic polyps
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11
Q

what is the most common polyp in the large bowel

A
  • hyperplastic polyp
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12
Q

size of hyper plastic polyps

A
  • most less than 3 mm in diameter
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13
Q

gross pathology of hyperplastic polyps

A
  • small sessile polyps

- slightly pale

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14
Q

histopathology of hyperplastic polyps

A
  • serrated crypts

- decreased goblet cells

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15
Q

which cells are premalignant and all dysplastic

most colon cancers arise from this

A
  • colonic adenomas
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16
Q

two growth patterns of polyps

which is easier to clip

A
  • sessile

- pedunculated - easier to clip because it’s basically on a a pedestal

17
Q

which architecture of an adenomatous polyp is the most common type with adenomatous epithelium arranged in closely-packed branching tubules having a cerebriform appearance at low power

18
Q

which architecture of an adenomatous polyp is where adenomatous epithelium takes the form of straight, elongated finger-like fronds extending from the muscular mucosal to the luminal surface

19
Q

which architecture of an adenomatous polyp is a mixture of tubular and villous architecture

20
Q

what makes epithelium adenomatous

A
  • pleomorphic colonic epithelium
  • nuclear pseudostratification
  • loss of cytoplasmic mucin
21
Q

what is a polyp that grossly appears benign but is later found by histologic examination to contain cancer

A
  • adenocarcinoma arising in a polyp
22
Q

symptoms of colon cancer

A
  • asymptomatic
  • obstruction
  • bleeding
  • weight loss
  • pencil thin stool
  • iron deficiency anemia
23
Q

what kind of lesion do we see with colon cancer

A
  • apple core lesion
24
Q

in the setting of a newly recognized iron deficiency anemia, what is the biggest concern

what is the test to rule out?

A
  • colorectal cancer

- colonoscopy

25
tumors in the right colon are usually
- polypoid | - fumigating exophytic masses
26
tumors involving the left colon are more
- annular lesions - apple-core lesions - bowel obstruction
27
histology of colorectal carcinoma
- adenocarcinoma within desomoplastic stroma | - invades bowel wall
28
nuclei of tumor cells in colorectal carcinoma
- oval or rounded nuclei
29
chromatin of tumor cells in colorectal carcinoma
- clumped chromatin | - nuclear polymorphism
30
nucleoli of tumor cells in colorectal carcinoma
- large or irregular
31
mucin secretion of tumor cells in colorectal carcinoma
- minimal to abundant | - signet ring pattern occurs
32
what happens if KRAS or BRAF mutations are present in colorectal carcinoma
- patient resistant to anti-EGFR therapies
33
what happens if MSI-high in colorectal carcinoma
- patient resistant to 5-fluorouracil therapy
34
genetics of familial adenomatous polyposis mutation where chance of cancer
- autosomal dominant - mutation of APC gene 100% chance of cancer
35
Peutz-Jehgers Syndrome symptoms
- multiple GI hamartomatous polyps | - pigmented spots on lips and buccal mucosa
36
genetics of Peutz-Jehgers Syndrome mutation where
- autosomal dominant | - mutation in STK11 gene