26 Colon Cancer

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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