Podcast
Questions and Answers
What histological feature is most characteristic of ulcerative colitis?
What histological feature is most characteristic of ulcerative colitis?
Which type of adenomatous polyp is characterized by being sessile and often larger than 2 cm?
Which type of adenomatous polyp is characterized by being sessile and often larger than 2 cm?
What is the primary histological difference observed in tubular adenomas compared to normal colonic mucosa?
What is the primary histological difference observed in tubular adenomas compared to normal colonic mucosa?
In colorectal carcinoma, which feature is commonly associated with lesions in the distal colon?
In colorectal carcinoma, which feature is commonly associated with lesions in the distal colon?
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What type of familial condition is Familial Adenomatous Polyposis classified as?
What type of familial condition is Familial Adenomatous Polyposis classified as?
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Which characteristic feature is NOT typically observed in the mucosa of active ulcerative colitis?
Which characteristic feature is NOT typically observed in the mucosa of active ulcerative colitis?
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Which clinical feature is associated with larger adenomatous polyps, specifically those larger than 2 cm?
Which clinical feature is associated with larger adenomatous polyps, specifically those larger than 2 cm?
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What describes the typical morphology of an apple core lesion in the context of colorectal cancer?
What describes the typical morphology of an apple core lesion in the context of colorectal cancer?
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Which term is used to describe the constricting lesions caused by colorectal carcinomas in the distal colon?
Which term is used to describe the constricting lesions caused by colorectal carcinomas in the distal colon?
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What histological change is observed regarding the nuclei in glands of tubular adenomas?
What histological change is observed regarding the nuclei in glands of tubular adenomas?
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Which feature is primarily characteristic of Crohn's disease?
Which feature is primarily characteristic of Crohn's disease?
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What is a common gross feature observed in Crohn's disease?
What is a common gross feature observed in Crohn's disease?
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Which histological feature is typically associated with ulcerative colitis?
Which histological feature is typically associated with ulcerative colitis?
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In Crohn's disease, which feature helps differentiate it from ulcerative colitis?
In Crohn's disease, which feature helps differentiate it from ulcerative colitis?
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What type of immune cell infiltration is commonly found in Crohn's disease?
What type of immune cell infiltration is commonly found in Crohn's disease?
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Which term describes the ulceration pattern typically seen in ulcerative colitis?
Which term describes the ulceration pattern typically seen in ulcerative colitis?
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Which of the following is not a characteristic feature of Crohn's disease?
Which of the following is not a characteristic feature of Crohn's disease?
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What is a distinguishing gross feature observed in the presence of Crohn's disease?
What is a distinguishing gross feature observed in the presence of Crohn's disease?
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Which type of inflammation is predominant in ulcerative colitis?
Which type of inflammation is predominant in ulcerative colitis?
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What is the significance of non-caseating epithelioid granulomas in Crohn's disease?
What is the significance of non-caseating epithelioid granulomas in Crohn's disease?
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Study Notes
Large Intestine Pathology
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Objectives:
- Identify types of inflammatory bowel disease.
- Describe the morphological changes of inflammatory bowel disease (gross and microscopic).
- Describe the morphological changes of adenoma and colorectal carcinoma (gross and microscopic).
Inflammatory Bowel Disease
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Crohn's Disease:
- Characterized by skip lesions (inflammation in segments).
- Inflammation affects all layers of the bowel wall (transmural).
- May show ulcers, fissures, and thickened bowel wall.
- Microscopically, inflammation extends through the wall, with nodular infiltrates and granulomas.
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Ulcerative Colitis:
- Inflammation is continuous along the mucosal surface, beginning in the rectum.
- Mucosa becomes eroded, showing pseudopolyps.
- Inflammation is primarily limited to the mucosa and upper submucosa (not transmural).
- Microscopically, crypt abscesses (inflammation in the glands) and loss of goblet cells are common findings.
Tumors of the Colon
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Adenomas:
- Sessile: Flat, wide polyps on the surface of the colon.
- Pedunculated: Stemmed polyps.
- Usually benign; however, larger ones (over 2 cm) have increased risk of carcinoma development.
- Tubular adenomas: More crowded, disorganized glands than normal mucosa; goblet cells are less numerous; hyperchromatic nuclei.
- Villous adenomas: Frond-like extensions, covered by dysplastic epithelium.
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Adenocarcinoma:
- Cecum: Polypoid or exophytic growth extending along one wall; obstruction is uncommon.
- Distal Colon: Annular, encircling lesions causing napkin-ring constrictions; margins are heaped, beaded, and firm, with ulceration in the midregion; lumen is narrowed.
- Villous Adenoma Site: Arising from villous adenomas, polypoid surface, reddish pink.
- Microscopically: Crowded nuclei, pleomorphism, loss of goblet cells; may contain bluish mucin.
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Familial Adenomatous Polyposis (FAP):
- Autosomal dominant inheritance pattern; numerous adenomas present.
Case Study
- A 45-year-old with a family history of colon cancer underwent a colonoscopy.
- Two small pedunculated and one sessile polyp (5 mm) were discovered.
- Possible diagnoses and predisposing factors, and diet's connection to colon cancer development should be considered.
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Description
Test your knowledge on the pathology of the large intestine, focusing on inflammatory bowel diseases such as Crohn's Disease and Ulcerative Colitis. This quiz will cover the morphological changes associated with these conditions as well as adenomas and colorectal carcinoma.
