All Pathology *colorectal CA and CA genetics

Cards (126)

  • Outline
    • Introduction
    • Objectives
    • Pathology
    • Questions
    • Summary
    • Assignment
    • References
  • Hepatitis
    • Acute - asymptomic
    • Acute symptomatic
    • Fulminant and Subfulminant
    • Chronic
  • Hepatitis
    • Inflammation
    • Clinical presentations
  • Chronic hepatitis
    • Stimulation of stellate cells
    • Liver cirrhosis
  • Hepatocytes
    • Apoptosis and Regeneration
    • Stimulation of cytokines (IFN, IL, PDGF, TGF)
  • Hepatocellular carcinoma
  • Ground glass hepatocyte
  • Liver cirrhosis
  • Interface hepatitis
  • Piecemeal necrosis
  • Tumour
    An abnormal growth which is excessive and uncoordinated and it refuses to stop growing even when the stimuli are absent
  • 3 common types of tumour in the colo-rectum
    • Polyps
    • Adenomas
    • Adenocarcinoma
  • Polyp
    A tumorous growth that protrude through mucosae into the lumen of the gastro intestinal tract with or without stalk
  • Types of polyps
    • Hyperplastic
    • Inflammatory
    • Lymphoid
    • Hamartomatous
    • Adenomatous
  • Inflammatory polyps

    Inflammed mucosa pseudo polyps
  • Lymphoid polyps
    Aggregate of intramucosal lymphocytes
  • Hyperplastic polyps

    May have no malignant potentials, results from decreased epithelial cell turnover
  • Hyperplastic polyps
    • Age occurrence 60-70yrs
  • Polyps
    • Less than <5cm, have smooth contour, protruding into the mucosae as single or multiple, composed of well formed glands with cripts lined by epithelial cells (goblets)
  • Hamartomatous polyps

    Collection of malformed glands and stroma
  • Types of hamartomatous polyps
    • Juvenile - composed of mucosae glands and lamina propria, larger-1 to 3cm, occurs in less than 5years
    • Adults - Retention polyps, lesser in size, may be in rectum, or all the segment of colon, rounded, smooth contour with stalk
  • Juvenile polyposis syndrome
    Rare autosomal dominant, 50-100 polyps in the GIT, carry risk of adenocarcinoma, have mutation in the gene that code TGF-B
  • Peutz-Jeghers polyps
    Single or multiple polyp are seen throughout the GIT
  • Peutz-Jeghers syndrome
    Multiple polyps, rare autosomal dominant
  • Peutz-Jeghers polyps
    • May be pendiunculated or arborizing network, composed of glands and connective tissue and smooth muscle, have increased potential of developing ca of pancreas, breast, lung, ovary, uterus
  • Peutz-Jeghers syndrome
    • Patients may have melanotic mucosae at the face and genital and palmar regions
  • Polyps in GIT, oral mucosa, face genitalia, palmer area

    • Have increased tendency of causing intussusception, may arise from adenomatious lesions, increased risk of developing ca of pancreas, breast, lung, ovary and uterus
  • Cowden syndrome
    Autosomal dominant, hamarmatous lesion derived from the 3 germinal layers, have increase tendency of developing Cancer of the thyroid, breast, and oral papillomas, acral keratosis and facial trichilemma, mutation in gene PTEN
  • Cronkhite canada
    Non-hereditory disorder, nail atrophy, skin pigmentation, alopecia
  • Adenomas
    Are intraepithelial neoplasms, pedunculated, sessile, occur within the age- groups of 40-60yrs, equal male to female ratio, may arise sporadically or genetic linkage
  • Adenomas
    • The more familial genetic predisposition, the more risk of colorectal carcinoma
  • Subtypes of adenomas based on epithelial cells
    • Tubular
    • Villous
    • Tubulovillous
  • Adenomas
    • More common are the tubular types, all arise from increased epithelial proliferation, have dyspalsia graded as low, moderate and severe (carcinoma in-situ)
  • Adenomas
    They are precursors to colorectal carcinoma, their precursors' risk are dependent on the size, histological architecture and severity of dysplasia
  • Tubular adenoma
    • Single or multiple, stalked or sessile, approx. 2.5cm, distributed in the GIT, composed of fibromuscuar stroma, blood vessels, lined by tall columnar
  • Villous adenomas
    • Larger in size-10cm, no stalk, multiple, velvety or cauliflower or frond-like, seen in rectum, colon, lined by dysplastic epithelium
  • Tubulovillous adenomas

    • Intermediate, stalk or sessile, dysplastic cells
  • Symptoms of adenomas

    Asymptomic, occult bleeding, symptomatic with presentation of anaemia, rectal bleeding, secretion of mucus rich with protein and potassium
  • Familial syndromes
    • Peutz-Jegher
    • Juvenile polyposis syn
    • Cowden
    • Familial Adenomatous polyposis(FAP)
    • Hereditary nonpolyposis
  • Familial syndromes
    Uncommon, autosomal dominant disorders, importance lies on occurrence of malignant transformation