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

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