Intestinal Polyps & Neoplasia

Hamartoma

Benign tumor that is the same type of tissue as the organ of biopsy

Juvenile Polyp

Juvenile Polyposis

Juvenile Polyposis

is a genetic condition with multiple juvenile polyps in the GI tract which increases the risk of colorectal cancer.

Common presentation for Juvenile Polyposis

<5 years old with rectal bleeding or anemia

SMAD4, BMPR1A

Juvenile Polyposis Genes

Peutz-Jegher Syndrome

is a genetic disorder with hamartomatous polyps in the GI tract and mucocutaneous pigmentation, increasing the risk of various cancers.

Peutz-Jegher Syndrome

STK11

Gene associated with Peutz-Jegher Syndrome

STK11 inheritance?

Autosomal Dominant

Peutz-Jhegers Polyp with arterizing smooth muscle

Characterize this Polyp

Inflammatory polyp without dysplasia

Characterize this Polyp

Hyperplastic polyp

Small polyp on the left side of the distal colon in >50 year old that is benign is most likely

Hyperplastic Polyp

Sessile Serrated Adenoma

Polyp that is easily confused with hyperplastic but is premalignant and on the right side of the colon (proximal)

Sessile serrated adenoma

The precursor to most colorectal cancers is

adenomatous polyp.

Adenoma Polyp

Pedunculated Adenoma Polyp

Tubular Adenoma

Villous Adenoma

Histology features of adenomatous epithelium

Blue (Hyperchromatic), Pencil shaped nuclei, pseudo stratified (jumping off basement membrane), lack of surface maturation (no goblet cells)

Colorectal cancer apple core sign

APC at 5q21

the “gate keeper” one of the first genes to get mutated on the development to colorectal cancer

Sessile serrated adenoma gene pathway -

Micro satellite instability (MSI) with mutations in MLH1-PMS2 or MHS2-MHS6

Familial Adenomatous Polyposis (FAP)

Autosomal dominant , mutation in APC with multiple polyps in the colon

Lynch Syndrome

Mutation in mismatch repair genes, inherited autosomal dominant, and leads to colon polyps

FAP

Neuroendocrine Tumor

Neuroendocrine/Carcinoid Tumor

Carcinoid Syndrome

A group of symptoms resulting from hormone-like substances released by carcinoid tumors — but requires metastasis to the liver

Tubular Adenoma

Tubular Adenoma

Tubulovillous Adenoma

Villous Adenoma

Neuroendocrine neoplasm of the intestine

Low grade apendocele mucinous neoplasm