Small Bowel NET

Q) 45 year old male with 2 cm Jejunal Neuroendocrine tumor ( NET).

Dota Scan Shows no metastasis What would be the best management in him?

a) Octreotide

b) Resection & Anastomoses of jejunum

c) Resection and Anastomoses with mesenteric excision

d) Radiotherapy

 

Small Bowel Adenocarcinoma & its Risk Factors

Q) Which of the following is not a risk factor/ least associated with small bowel adenocarcinoma ?

a) Familial adenomatous polyposis (FAP)

b) Hereditary nonpolyposis colorectal cancer

c) Peutz-Jeghers syndrome

d) Juvenile polyposis coli


MOre Questions on Small Bowel Q 1-5

 

Ans

d

Juvenile Polyposis Coli is least associated with small bowel adenocarcinoma

Risk factors for Small bowel Adenocarcinoma are 

  1. Hereditary polyps - familial adenomatous polyposis (FAP), hereditary nonpolyposis
    colorectal cancer, Peutz-Jeghers syndrome

2.  Crohn disease, gluten-sensitive enteropathy (i.e., celiac sprue), prior peptic ulcer disease, cystic fibrosis, and biliary diversion (i.e., previous cholecystectomy).

3. Lifestyle

Smoking, heavy alcohol consumption (>80 g/day of ethanol), and consumption of red meat or salted food

4. Genetic -

Kras,  5q (APC gene), 17q (p53 gene), and 18q  and DPC4 , SMAD 4, MSI H

 

Crohn Disease Pathology

Q) Which of the following is not characteristic of Crohn Disease  : * (From AIIMS 2020 November GI)  

a) Granular mucosa
b) Transmural involvement
c) Skip lesions
d) Giant cell granuloma

Ans a ) Granular Mucosa- This is a feature of ulcerative colitis ( Table 49-7 Sabiston 20) 

The typical gross appearance of ulcerative colitis is hyperemic mucosa.

Friable and granular mucosa is common in more severe cases, and ulceration may not be readily evident. ( Saby 1340) 

IN Crohn disease - Microscopically, there are focal areas of chronic inflammation involving all layers of the intestinal wall with lymphoid
aggregates. Non-caseating giant cell granulomas are found in 60% of patients and when present clearly allow a confident diagnosis of CD.

( Bailey 1242)