jean robert
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A 60 y.o. caucasian woman presents to your office with diarrhea containing a lot of mucoid material. Despite not eating much for the past 2 days, her diarrhea has not decreased.She has no other symptoms.Colonoscopy is scheduled and reveals a cauliflower-like mass in the sigmoid colon.Lab studies show hypokalemia. This patient most likely suffers from which of the following?
a.-Peutz Jeghers Syndrome
b.-Colonic Diverticulum
c.-Carcinoid tumor
d.-Villous adenoma
e.-Hamartomatous polyp
f.-Signet ring cell carcinoma
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| new_n_lost
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d.-Villous adenoma
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| drmohamed811
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did you chooce villous adenoma by exculsion of other options? or there is a specific presentation in the stem of the question that favour villous adenoma
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| al-fateh
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as i know the villous adenoma resimplethe VIPOMA as both incresae the mucous sec leading to hypokalemia (dirrehia cant stop by fasting)
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| rock
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d-villous adenoma ? pt has symptoms of adenocarcinoma of colon...villous adenoma is associated most with carcinoma of colon.
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| jean robert
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D
Colonic adenomatous polyps are divided into 3 types according to their histologic appearance.
TUBULAR adenomas are composed of dysplastic colonic mucosal cells that are from
tubular-shaped glands.
In VILLOUS adenomas, dysplastic epithelial cells villi-like projections that extend
from the polyp surface down to the stroma.
TUBULOVILLOUS adenomas show a mixture of the 2 patterns.
Tubular adenomas tend to be smaller and pedunculated, while villous adenomas are larger and more commonly sessile. Sometimes villous adenomas can have velvety or cauliflower-like projections.
The patient s lesion is mosy consistent with villous adenoma.Although most of colon adenomas are asymptomatic,larger ones can cause a number of symptoms:
1.-Lower intestine bleeding causes guaiac-positive stool(fecal occult blood testing)and microcytic hypochromic anemia.The bleeding is usually unknown to the patient, but overt bleeding may also occur.
2.-Partial intestinal obstruction can manifest with bowel habit changes,crampy abdominal pain,constipation and abdominal distention.
**3.-Villous adenomas may secrete large amounts of MUCUS,leading to seretory diarrhea
4.-Villous adenomas have a high risk of progression to adenocarcinoma
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| lq2006
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