Large Intestine Pathology Quiz عملي
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Questions and Answers

What histological feature is most characteristic of ulcerative colitis?

  • Presence of intestinal metaplasia
  • Increased number of goblet cells
  • Keratinization of the epithelium
  • Crypt abscesses containing neutrophilic exudate (correct)

Which type of adenomatous polyp is characterized by being sessile and often larger than 2 cm?

  • Hyperplastic polyp
  • Tubular adenoma
  • Villous adenoma (correct)
  • Pedunculated polyp

What is the primary histological difference observed in tubular adenomas compared to normal colonic mucosa?

  • Crowded and disorganized glandular structure (correct)
  • Greater number of goblet cells
  • Presence of minimal inflammatory cells
  • Thickened muscularis layer

In colorectal carcinoma, which feature is commonly associated with lesions in the distal colon?

<p>Annular constricting lesions with ulceration (D)</p> Signup and view all the answers

What type of familial condition is Familial Adenomatous Polyposis classified as?

<p>Autosomal dominant (C)</p> Signup and view all the answers

Which characteristic feature is NOT typically observed in the mucosa of active ulcerative colitis?

<p>Intact goblet cells (A)</p> Signup and view all the answers

Which clinical feature is associated with larger adenomatous polyps, specifically those larger than 2 cm?

<p>Significantly increased risk of carcinoma (D)</p> Signup and view all the answers

What describes the typical morphology of an apple core lesion in the context of colorectal cancer?

<p>Polypoid and extending along one wall (C)</p> Signup and view all the answers

Which term is used to describe the constricting lesions caused by colorectal carcinomas in the distal colon?

<p>Napkin-ring lesions (C)</p> Signup and view all the answers

What histological change is observed regarding the nuclei in glands of tubular adenomas?

<p>Enlarged and hyperchromatic nuclei (B)</p> Signup and view all the answers

Which feature is primarily characteristic of Crohn's disease?

<p>Transmural inflammation with granulomas (C)</p> Signup and view all the answers

What is a common gross feature observed in Crohn's disease?

<p>Creeping fat along the serosal surface (C)</p> Signup and view all the answers

Which histological feature is typically associated with ulcerative colitis?

<p>Superficial inflammation limited to mucosa (C)</p> Signup and view all the answers

In Crohn's disease, which feature helps differentiate it from ulcerative colitis?

<p>Segmented distribution of lesions (D)</p> Signup and view all the answers

What type of immune cell infiltration is commonly found in Crohn's disease?

<p>Lymphoid aggregates with granulomas (B)</p> Signup and view all the answers

Which term describes the ulceration pattern typically seen in ulcerative colitis?

<p>Superficial ulcers (D)</p> Signup and view all the answers

Which of the following is not a characteristic feature of Crohn's disease?

<p>Continuous pattern of lesions (B)</p> Signup and view all the answers

What is a distinguishing gross feature observed in the presence of Crohn's disease?

<p>Reddish indurated adipose tissue (B)</p> Signup and view all the answers

Which type of inflammation is predominant in ulcerative colitis?

<p>Superficial and limited to the mucosa (C)</p> Signup and view all the answers

What is the significance of non-caseating epithelioid granulomas in Crohn's disease?

<p>They are diagnostic hallmarks for the disease (C)</p> Signup and view all the answers

Flashcards

Ulcerative Colitis Inflammation

Inflammation in ulcerative colitis mainly affects the mucosa and submucosa, characterized by ulcers eroding the mucosa and undermining surrounding tissue.

Crypt abscesses in ulcerative colitis

Microscopic features of ulcerative colitis include crypt abscesses, a collection of neutrophils within glandular lumens, and submucosal inflammation. These also have abnormal glands with fewer goblet cells and unusual nuclei.

Sessile Polyp

A type of polyp in the colon, typically small, that has a smooth surface and a wide base.

Pedunculated Polyp

A polyp in the colon attached to the wall by a thin stalk, resembling a mushroom.

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Tubular Adenoma

A type of polyp with tubular glands that are more crowded and disorganized compared to normal colonic mucosa.

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Villous Adenoma

Large adenomatous polyps with a velvety or cauliflower-like surface, often sessile, and greater risk of cancer than smaller polyps.

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Familial Adenomatous Polyposis

An inherited condition with increased risk of colon cancer, causing numerous polyps to develop in the colon.

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Proximal Colon Cancer

Colon cancer that often forms a bulging mass, especially in the proximal colon (cecum and ascending colon), and rarely causes obstruction.

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Distal Colon Cancer

Colon cancer that usually forms a ring-shaped constriction, narrowing the colon lumen, particularly in the distal colon.

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Napkin-Ring Lesion

A characteristic appearance of distal colon cancer where the narrowed lumen resembles a napkin ring.

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Crohn's disease

An inflammatory bowel disease characterized by transmural inflammation, skip lesions, and creeping fat. The inflammation extends from the mucosa through the submucosa and muscularis, appearing as nodular infiltrates on the serosal surface with pale granulomatous centers.

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Gross features of Crohn's disease

The middle portion of the terminal ileum has a thickened wall and the mucosa has lost the regular folds. The serosal surface demonstrates reddish indurated adipose tissue that creeps over the surface.

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Microscopic features of Crohn's disease

Deep ulcers, fissures, transmural inflammation, and epithelioid granulomas are diagnostic hallmarks. Features may overlap with ulcerative colitis.

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Ulcerative colitis

Inflammation tends to be continuous along the mucosal surface, often beginning in the rectum. The mucosa becomes eroded, leaving islands of mucosa called 'pseudopolyps'.

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Pseudopolyps

These are the remaining islands of mucosa after the continuous inflammation erodes away the surrounding mucosal lining.

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Microscopic features of ulcerative colitis

Inflammation is usually limited to the mucosa and upper submucosa. No transmural inflammation like Crohn's disease.

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Adenoma

A type of benign tumor in the colon that can be precursor to colorectal cancer.

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Colorectal carcinoma

Cancerous tumor of the colorectal region. Can be characterized by the location of the tumor: right-sided, left-sided, or rectal.

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Right-sided colorectal carcinoma

This refers to the location of a colorectal carcinoma, typically associated with more advanced disease and a poorer prognosis.

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Left-sided colorectal carcinoma

This refers to the location of a colorectal carcinoma, typically associated with obstruction and a better prognosis.

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Study Notes

Large Intestine Pathology

  • 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

  • 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.

  • 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

  • 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.

  • 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.

  • 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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Related Documents

Large Bowel Pathology PDF

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.

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