26 Colon Cancer

Polyps

Hyperplastic

  • benign.

Adenomatous

  • left: sessile
  • right: pedunculated

  • histology

  • villi projection
  • dysplastic cells

Polyp Symptoms

  • pts with polyp > 1cm in diameter and numbers are at increased risks of developing metachronous
  • more screening

Juvenile

  • no dysplasia
  • fall off and bleed, iron deficiency anemia

Peutz-Jeghers

  • present with spots around lips and polyps

Genetics of Colon Cancer

  • aspirin to prevent colon cancer

Chromosomal Instability

  • spontaneous mutations

  • cell mutated to have APC
  • surrounding copies also have mutated APC

FAP

  • born with entire colon have APC mutation

Gardner

  • bumps all over body
  • bump at jaw

  • children born with dark spot

Turcot

Microsatellite

  • separate from bulk of genetic material (satellites)

HNPCC

COX 2

DCC

Colon Cancer

  • right side: bleed slowly, anemia
  • exophytic: grow out from the side, does not obstruct stool, symptoms from bleeding

CEA