Difference between revisions of "Colorectal tumours"

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Colorectal tumours (view source)

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==Staging of colorectal cancer==
==Staging of colorectal cancer==
*"Adenocarcinoma in situ" and "high-grade dysplasia" is used interchangeably by many in the colon and rectum.
{{Main|Colorectal cancer staging}}
**Splitting hairs - ''adenocarcinoma in situ'' is ''invasion into the lamina propria'', high-grade dysplasia does not have lamina propria invasion. Ergo, the difference amounts to seeing a [[desmoplastic stroma]] (adenocarcinoma) or not seeing one (dysplasia).
 
Staging of tumours:
*Tis - in situ (intramucosal).
*T1 - into submucosa (through mucularis mucosae).
**This is '''different than elsewhere''', e.g. in the ''small bowel'' tumour cells in the ''lamina propria'' is defined as T1.  The rationale for the ''T1'' definition in CRC is that no lymphatics are present in the mucosa, ergo no risk of distant spread.
*T2 - into muscularis propria.
*T3 - into fat beyond musclaris propria.
*T4 - into something else.
 
Nodes:
*N0 - no positive nodes.
*N1 - 1-3 positive nodes.
*N2 - 4+ positive nodes.
 
Notes:
*Memory device for N2 = 4+ +ve LNs: the number ''four'' in chinese sounds like ''death''.<ref>URL: [http://en.wikipedia.org/wiki/Numbers_in_Chinese_culture#Four http://en.wikipedia.org/wiki/Numbers_in_Chinese_culture#Four]. Accessed on: 28 June 2011.</ref>
 
==Overall stage==
===Simple version===
Tumour/node grade for stage:<ref>{{Ref TN2006| GS27}}</ref>
*Stage I - '''T1 or T2''' N0 M0.
*Stage II - '''T3 or T4''' N0 M0.
*Stage III - Tx '''N1 or N2''' M0.
*Stage IV - Tx Nx '''M1'''.
 
===Complex version===
Detailed tumour/node grade for stage:<ref>[http://www.cancer.org/docroot/CRI/content/CRI_2_4_3X_How_is_colon_and_rectum_cancer_staged.asp http://www.cancer.org/docroot/CRI/content/CRI_2_4_3X_How_is_colon_and_rectum_cancer_staged.asp]</ref>
*Stage I - T1 or T2.
*Stage IIA - T3.
*Stage IIB - T4.
*Stage IIIA - T1 N1 or T2 N1.
*Stage IIIB - T3 N1 or T4 N1.
*Stage IIIC - Tx N2.
*Stage IV - Tx Nx M1.


==Pathogenesis of colorectal carcinoma==
==Pathogenesis of colorectal carcinoma==
Michael
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