Tumors of the Intestines Quiz
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Questions and Answers

What is the primary characteristic of familial polyposis?

  • Acquired disease due to lifestyle choices
  • Mutation in the APC gene (correct)
  • Presence of single polyp only
  • Manifests only after age 50

    • Which dietary factors are associated with an increased risk of colonic carcinoma?

  • Low fat dairy consumption
  • High red meat and animal fat diet (correct)
  • Low carbohydrate intake
  • High fiber diet

    • At which site is colonic carcinoma most commonly found?

  • Transverse colon
  • Descending colon
  • Cecum
  • Recto-sigmoid colon (correct)

    • What type of carcinoma is most commonly associated with colonic carcinoma?

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

    Which of the following is NOT classified as a non-neoplastic colorectal polyp?

    <p>Adenomatous polyp (A)</p> Signup and view all the answers

    What is a common clinical manifestation of colonic carcinoma?

    <p>Asymptomatic at first (B)</p> Signup and view all the answers

    Which cellular characteristic may be observed in well-differentiated adenocarcinoma of the colon?

    <p>Excessive mucin production (A)</p> Signup and view all the answers

    What mechanism describes the spread of colonic carcinoma to the liver?

    <p>Blood spread (A)</p> Signup and view all the answers

    What is the most common site for the occurrence of carcinoid tumors?

    <p>Appendix (A)</p> Signup and view all the answers

    Which characteristic is associated with the microscopic appearance of carcinoid tumors?

    <p>Sheets of small cohesive cells with scant granular cytoplasm (C)</p> Signup and view all the answers

    Which of the following is a clinical feature of carcinoid syndrome?

    <p>Cutaneous flushing (A)</p> Signup and view all the answers

    Which risk factor is NOT associated with adenocarcinoma of the small intestine?

    <p>Diabetes mellitus (A)</p> Signup and view all the answers

    What is a defining feature of benign tumors known as neoplastic polyps?

    <p>Can be sessile or pedunculated (D)</p> Signup and view all the answers

    Which of the following secretory products is associated with carcinoid tumors leading to Zollinger Ellison syndrome?

    <p>Gastrin (B)</p> Signup and view all the answers

    What type of tumor accounts for 3-6% of all gastrointestinal tumors?

    <p>Carcinoid tumors (A)</p> Signup and view all the answers

    Which benign tumors may be found in the large intestine?

    <p>Adenomas (B)</p> Signup and view all the answers

    Flashcards

    Carcinoid Tumor Location

    Most frequently found in the appendix, ileum, rectum, stomach, and lungs.

    Carcinoid Tumors Appearance

    Small, firm, yellow-brown tumors, often solitary in the appendix and rectum, but multiple elsewhere.

    Carcinoid Tumor Cells

    Islands or sheets of small, uniform cells with scant cytoplasm and stippled nuclei, separated by fibrous stroma, often staining positive for neuroendocrine markers.

    Carcinoid Syndrome Symptoms

    Symptoms include flushing, diarrhea, abdominal cramps, bronchoconstriction, and possible liver enlargement (due to spread).

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    Carcinoid Tumor Origin

    Derived from neuroendocrine cells (argentaffin cells) found throughout the body.

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    Small Intestine Tumors

    Rare tumors comprising 3-6% of gastrointestinal tumors.

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    Adenocarcinoma of Small Intestine

    Rare type that usually encircles the bowel, and most commonly arises in the duodenum.

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    Risk Factors of Small Intestine Adenocarcinoma

    Celiac disease, Crohn's disease, and diverticulosis are potential risk factors.

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    Familial Polyposis

    A hereditary disease causing numerous colon polyps, often leading to colon cancer.

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    Colonic Carcinoma

    Cancer of the colon; occurs frequently in older adults and is linked to diet and genetics.

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    Adenomatous Polyp

    A common type of precancerous polyp in the colon.

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    Risk Factors for Colon Cancer

    Low fiber, high fat diets, inherited conditions (like familial polyposis), and inflammatory bowel disease can increase colon cancer risk.

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    Colonic Carcinoma Types

    Colonic cancer may be polypoid (a growth), ulcerative (a sore), or infiltrative (spreading through tissues).

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    Colonic Carcinoma Spread

    Cancer can spread through lymph vessels, blood vessels, or directly to nearby organs.

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    Adenocarcinoma (Colon)

    The most common type of colon cancer, characterized by cancerous glandular cells.

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    Clinical Manifestations of Colon Cancer

    Early symptoms may be absent, but later symptoms can include fatigue, anemia, abdominal pain, and obstruction.

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    Study Notes

    Tumors of the Intestines

    • Topics discussed include tumors of the small intestine, large intestine, gastrointestinal lymphoma, and tumors of the appendix.

    Tumors of the Small Intestine

    • Rare, comprising 3-6% of gastrointestinal tumors.
    • Benign tumors include leiomyoma, adenomatous polyps, and lipoma.
    • Malignant tumors include carcinoid tumors and adenocarcinoma.

    Carcinoid Tumor

    • Originates from neuroendocrine cells (argentaffin cells) distributed throughout various organs.
    • Common sites include the appendix (most common), ileum, rectum, stomach, and lungs.
    • Gross appearance: small, firm, yellow-brown, intramural or submucosal, solitary in the appendix and rectum, multiple in other areas.
    • Microscopic features: islands or sheets of small uniform cohesive cells with scant granular cytoplasm and stippled nuclei. The cells are separated by dense fibrous stroma and stain positive for neuroendocrine markers (e.g., chromogranin).
    • Clinical findings: typically asymptomatic; potential for secretory products leading to Zollinger-Ellison syndrome (gastrin), Cushing syndrome (corticotropin), or carcinoid syndrome (serotonin). Laboratory findings may include increased 5-hydroxyindoleacetic acid (5-HIAA) in the urine.
    • Carcinoid syndrome features: cutaneous flushing, diarrhea, abdominal cramps, bronchoconstriction, hepatomegaly (due to metastases), and tricuspid and pulmonary valve fibrosis.

    Adenocarcinoma of the Small Intestine

    • Rare.
    • Commonly encircles the bowel.
    • Arises in the duodenum.
    • Risk factors include celiac disease, Crohn's disease, and diverticulosis.

    Tumors of the Large Intestine: Benign Tumors - Neoplastic Polyps (Adenomas)

    • Can be sessile or pedunculated.
    • Predominantly located in the rectum and sigmoid colon.
    • Types include tubular, villous, and tubulo-villous.

    Familial Polyposis (Adenomatous Polyposis Coli, APC)

    • Hereditary autosomal dominant disease.
    • Characterized by hundreds of polyps in the colon (and possibly other sites in the gastrointestinal tract).
    • Mutations in the APC gene (chromosome 5) or the MUTYH gene (chromosome 1).
    • Virtually 100% will develop invasive adenocarcinoma by age 40.
    • Polyp formation is a precancerous condition.

    Large Intestine: Non-Neoplastic Polyps

    • Hyperplastic polyps.
    • Hamartomatous polyps (juvenile or retention polyps).
    • Inflammatory polyps (pseudopolyps).
    • Lymphoid polyps (hyperplasia of submucosal lymphoid tissue).

    Large Intestine: Malignant Tumors

    • Carcinoma.
    • Malignant lymphoma.
    • Leiomyosarcoma.

    Colonic Carcinoma

    • Worldwide high incidence in industrial areas.
    • Higher frequency in males (2:1).
    • Age incidence: 50-70 years.
    • Risk factors: low fiber diet, high carbohydrate diet, high red meat and animal fat consumption, adenomatous polyps, hereditary polyposis, and ulcerative colitis.
    • Common sites and incidence:
      • Rectosigmoid colon: 55%
      • Cecum and ascending colon: 25%
      • Transverse colon: 12%
      • Descending colon: 8%
    • Gross appearance:
      • Polypoid type: ascending colon
      • Ulcerative type: any site
      • Infiltrative type: descending colon and rectum; complicated by stenosis and obstruction
    • Microscopic features: commonly adenocarcinoma (which may be well-differentiated, undifferentiated, mucoid, or signet ring cells); squamous cell carcinoma; or carcinoid tumor.
    • Clinical manifestations: initially asymptomatic; fatigue, weakness, iron deficiency anemia, abdominal discomfort, and progressive bowel obstruction.
    • Spread: direct spread to the wall; lymphatic spread to mesenteric and periaortic nodes; blood spread to liver, lung, brain, and bone; and transcelomic spread to the ovary (Krukenberg tumor).
    • Prognosis: 100% 5-year survival in lesions limited to the mucosa. 25% 5-year survival in invasive tumors.

    Intestinal Lymphoma

    • Gastrointestinal lymphoma is a B-cell type lymphoma arising from mucosa-associated lymphoid tissue (MALT).
    • Stomach: 55%
    • Small intestine: 25%
    • Colon: 20%
    • Gross appearance: early lesions are plaque-like; advanced lesions are full mural thickness or polypoid protruding into the lumen.
    • Microscopic: neoplastic lymphocytes infiltrate and replace normal structures.

    Appendicular Tumors

    • Carcinoid tumor (common).
    • Mucinous cystadenoma (rare): secretes mucus; may rupture; forms mucocele.
    • Mucinous cystadenocarcinoma (rare): peritoneal implants; neoplastic mucin-producing cells; pseudomyxoma peritonei (fatal).

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    Tumors of Intestines PDF

    Description

    Test your knowledge on various tumors of the intestines, including the small intestine, large intestine, gastrointestinal lymphoma, and appendix tumors. This quiz covers benign and malignant tumors, with a focus on carcinoid tumors and their characteristics.

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