Colorectal cancer differential diagnosis: Difference between revisions
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* Necrotic debris in glandular lumina | * Necrotic debris in glandular lumina | ||
* Desmoplastic reaction (sign of invasion) | * Desmoplastic reaction (sign of invasion) | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" |[[Biopsy]] and [[histopathological]] analysis | ||
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| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Peutz-Jeghers syndrome]]<br><ref name="pmid27298573">{{cite journal |vauthors=Zhong ME, Niu BZ, Ji WY, Wu B |title=Laparoscopic restorative proctocolectomy with ileal pouch-anal anastomosis for Peutz-Jeghers syndrome with synchronous rectal cancer |journal=World J. Gastroenterol. |volume=22 |issue=22 |pages=5293–6 |date=June 2016 |pmid=27298573 |doi=10.3748/wjg.v22.i22.5293 |url=}}</ref><ref name="KopacovaTacheci20092">{{cite journal|last1=Kopacova|first1=Marcela|last2=Tacheci|first2=Ilja|last3=Rejchrt|first3=Stanislav|last4=Bures|first4=Jan|title=Peutz-Jeghers syndrome: Diagnostic and therapeuticapproach|journal=World Journal of Gastroenterology|volume=15|issue=43|year=2009|pages=5397|issn=1007-9327|doi=10.3748/wjg.15.5397}}</ref><ref name="GiardielloTrimbath2006">{{cite journal|last1=Giardiello|first1=F|last2=Trimbath|first2=J|title=Peutz-Jeghers Syndrome and Management Recommendations|journal=Clinical Gastroenterology and Hepatology|volume=4|issue=4|year=2006|pages=408–415|issn=15423565|doi=10.1016/j.cgh.2005.11.005}}</ref><ref name="BeggsLatchford2010">{{cite journal|last1=Beggs|first1=A. D.|last2=Latchford|first2=A. R.|last3=Vasen|first3=H. F. A.|last4=Moslein|first4=G.|last5=Alonso|first5=A.|last6=Aretz|first6=S.|last7=Bertario|first7=L.|last8=Blanco|first8=I.|last9=Bulow|first9=S.|last10=Burn|first10=J.|last11=Capella|first11=G.|last12=Colas|first12=C.|last13=Friedl|first13=W.|last14=Moller|first14=P.|last15=Hes|first15=F. J.|last16=Jarvinen|first16=H.|last17=Mecklin|first17=J.-P.|last18=Nagengast|first18=F. M.|last19=Parc|first19=Y.|last20=Phillips|first20=R. K. S.|last21=Hyer|first21=W.|last22=Ponz de Leon|first22=M.|last23=Renkonen-Sinisalo|first23=L.|last24=Sampson|first24=J. R.|last25=Stormorken|first25=A.|last26=Tejpar|first26=S.|last27=Thomas|first27=H. J. W.|last28=Wijnen|first28=J. T.|last29=Clark|first29=S. K.|last30=Hodgson|first30=S. V.|title=Peutz-Jeghers syndrome: a systematic review and recommendations for management|journal=Gut|volume=59|issue=7|year=2010|pages=975–986|issn=0017-5749|doi=10.1136/gut.2009.198499}}</ref><ref name="KopacovaTacheci20093">{{cite journal|last1=Kopacova|first1=Marcela|last2=Tacheci|first2=Ilja|last3=Rejchrt|first3=Stanislav|last4=Bures|first4=Jan|title=Peutz-Jeghers syndrome: Diagnostic and therapeuticapproach|journal=World Journal of Gastroenterology|volume=15|issue=43|year=2009|pages=5397|issn=1007-9327|doi=10.3748/wjg.15.5397}}</ref> | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Peutz-Jeghers syndrome]]<br><ref name="pmid27298573">{{cite journal |vauthors=Zhong ME, Niu BZ, Ji WY, Wu B |title=Laparoscopic restorative proctocolectomy with ileal pouch-anal anastomosis for Peutz-Jeghers syndrome with synchronous rectal cancer |journal=World J. Gastroenterol. |volume=22 |issue=22 |pages=5293–6 |date=June 2016 |pmid=27298573 |doi=10.3748/wjg.v22.i22.5293 |url=}}</ref><ref name="KopacovaTacheci20092">{{cite journal|last1=Kopacova|first1=Marcela|last2=Tacheci|first2=Ilja|last3=Rejchrt|first3=Stanislav|last4=Bures|first4=Jan|title=Peutz-Jeghers syndrome: Diagnostic and therapeuticapproach|journal=World Journal of Gastroenterology|volume=15|issue=43|year=2009|pages=5397|issn=1007-9327|doi=10.3748/wjg.15.5397}}</ref><ref name="GiardielloTrimbath2006">{{cite journal|last1=Giardiello|first1=F|last2=Trimbath|first2=J|title=Peutz-Jeghers Syndrome and Management Recommendations|journal=Clinical Gastroenterology and Hepatology|volume=4|issue=4|year=2006|pages=408–415|issn=15423565|doi=10.1016/j.cgh.2005.11.005}}</ref><ref name="BeggsLatchford2010">{{cite journal|last1=Beggs|first1=A. D.|last2=Latchford|first2=A. R.|last3=Vasen|first3=H. F. A.|last4=Moslein|first4=G.|last5=Alonso|first5=A.|last6=Aretz|first6=S.|last7=Bertario|first7=L.|last8=Blanco|first8=I.|last9=Bulow|first9=S.|last10=Burn|first10=J.|last11=Capella|first11=G.|last12=Colas|first12=C.|last13=Friedl|first13=W.|last14=Moller|first14=P.|last15=Hes|first15=F. J.|last16=Jarvinen|first16=H.|last17=Mecklin|first17=J.-P.|last18=Nagengast|first18=F. M.|last19=Parc|first19=Y.|last20=Phillips|first20=R. K. S.|last21=Hyer|first21=W.|last22=Ponz de Leon|first22=M.|last23=Renkonen-Sinisalo|first23=L.|last24=Sampson|first24=J. R.|last25=Stormorken|first25=A.|last26=Tejpar|first26=S.|last27=Thomas|first27=H. J. W.|last28=Wijnen|first28=J. T.|last29=Clark|first29=S. K.|last30=Hodgson|first30=S. V.|title=Peutz-Jeghers syndrome: a systematic review and recommendations for management|journal=Gut|volume=59|issue=7|year=2010|pages=975–986|issn=0017-5749|doi=10.1136/gut.2009.198499}}</ref><ref name="KopacovaTacheci20093">{{cite journal|last1=Kopacova|first1=Marcela|last2=Tacheci|first2=Ilja|last3=Rejchrt|first3=Stanislav|last4=Bures|first4=Jan|title=Peutz-Jeghers syndrome: Diagnostic and therapeuticapproach|journal=World Journal of Gastroenterology|volume=15|issue=43|year=2009|pages=5397|issn=1007-9327|doi=10.3748/wjg.15.5397}}</ref> | ||
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* [[Hamartoma|Hamartomatous]] [[Polyps|mucosal polyps]] with central core of branching smooth muscle associated with mucosa | * [[Hamartoma|Hamartomatous]] [[Polyps|mucosal polyps]] with central core of branching smooth muscle associated with mucosa | ||
* Smaller [[Polyp|polyps]] may lack the prominent arborizing smooth muscle | * Smaller [[Polyp|polyps]] may lack the prominent arborizing smooth muscle | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" |[[Genetic testing]] for [[STK11]] and [[colonoscopy]] | ||
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* Peripheral nuclear palisading | * Peripheral nuclear palisading | ||
* Granular eosinophilic cytoplasm. | * Granular eosinophilic cytoplasm. | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" |[[Biopsy]] and [[Histopathology|histopathological analysis]] | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Juvenile polyposis syndrome|Juvenile Polyposis Coli]]<ref name="pmid7054044">{{cite journal |vauthors=Grotsky HW, Rickert RR, Smith WD, Newsome JF |title=Familial juvenile polyposis coli. A clinical and pathologic study of a large kindred |journal=Gastroenterology |volume=82 |issue=3 |pages=494–501 |date=March 1982 |pmid=7054044 |doi= |url=}}</ref><ref name="pmid22171123">{{cite journal |vauthors=Brosens LA, Langeveld D, van Hattem WA, Giardiello FM, Offerhaus GJ |title=Juvenile polyposis syndrome |journal=World J. Gastroenterol. |volume=17 |issue=44 |pages=4839–44 |date=November 2011 |pmid=22171123 |pmc=3235625 |doi=10.3748/wjg.v17.i44.4839 |url=}}</ref><ref name="pmid22965402">{{cite journal |vauthors=Latchford AR, Neale K, Phillips RK, Clark SK |title=Juvenile polyposis syndrome: a study of genotype, phenotype, and long-term outcome |journal=Dis. Colon Rectum |volume=55 |issue=10 |pages=1038–43 |date=October 2012 |pmid=22965402 |doi=10.1097/DCR.0b013e31826278b3 |url=}}</ref><ref name="pmid229654023">{{cite journal |vauthors=Latchford AR, Neale K, Phillips RK, Clark SK |title=Juvenile polyposis syndrome: a study of genotype, phenotype, and long-term outcome |journal=Dis. Colon Rectum |volume=55 |issue=10 |pages=1038–43 |date=October 2012 |pmid=22965402 |doi=10.1097/DCR.0b013e31826278b3 |url=}}</ref><ref name="pmid229654022">{{cite journal |vauthors=Latchford AR, Neale K, Phillips RK, Clark SK |title=Juvenile polyposis syndrome: a study of genotype, phenotype, and long-term outcome |journal=Dis. Colon Rectum |volume=55 |issue=10 |pages=1038–43 |date=October 2012 |pmid=22965402 |doi=10.1097/DCR.0b013e31826278b3 |url=}}</ref> | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Juvenile polyposis syndrome|Juvenile Polyposis Coli]]<ref name="pmid7054044">{{cite journal |vauthors=Grotsky HW, Rickert RR, Smith WD, Newsome JF |title=Familial juvenile polyposis coli. A clinical and pathologic study of a large kindred |journal=Gastroenterology |volume=82 |issue=3 |pages=494–501 |date=March 1982 |pmid=7054044 |doi= |url=}}</ref><ref name="pmid22171123">{{cite journal |vauthors=Brosens LA, Langeveld D, van Hattem WA, Giardiello FM, Offerhaus GJ |title=Juvenile polyposis syndrome |journal=World J. Gastroenterol. |volume=17 |issue=44 |pages=4839–44 |date=November 2011 |pmid=22171123 |pmc=3235625 |doi=10.3748/wjg.v17.i44.4839 |url=}}</ref><ref name="pmid22965402">{{cite journal |vauthors=Latchford AR, Neale K, Phillips RK, Clark SK |title=Juvenile polyposis syndrome: a study of genotype, phenotype, and long-term outcome |journal=Dis. Colon Rectum |volume=55 |issue=10 |pages=1038–43 |date=October 2012 |pmid=22965402 |doi=10.1097/DCR.0b013e31826278b3 |url=}}</ref><ref name="pmid229654023">{{cite journal |vauthors=Latchford AR, Neale K, Phillips RK, Clark SK |title=Juvenile polyposis syndrome: a study of genotype, phenotype, and long-term outcome |journal=Dis. Colon Rectum |volume=55 |issue=10 |pages=1038–43 |date=October 2012 |pmid=22965402 |doi=10.1097/DCR.0b013e31826278b3 |url=}}</ref><ref name="pmid229654022">{{cite journal |vauthors=Latchford AR, Neale K, Phillips RK, Clark SK |title=Juvenile polyposis syndrome: a study of genotype, phenotype, and long-term outcome |journal=Dis. Colon Rectum |volume=55 |issue=10 |pages=1038–43 |date=October 2012 |pmid=22965402 |doi=10.1097/DCR.0b013e31826278b3 |url=}}</ref> | ||
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* Filiform, multilobated forms with increased glandular-to-stroma ratio in nonclassic or atypical polyps | * Filiform, multilobated forms with increased glandular-to-stroma ratio in nonclassic or atypical polyps | ||
* Areas of conventional dysplasia | * Areas of conventional dysplasia | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" |Diagnostic criteria on the basis of history, colonoscopy, and genetics | ||
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| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Gastrointestinal stromal tumor|Gastrointestinal Stromal Tumors (GIST)]]<ref name="pmid24778074">{{cite journal |vauthors=Niazi AK, Kaley K, Saif MW |title=Gastrointestinal stromal tumor of colon: a case report and review of literature |journal=Anticancer Res. |volume=34 |issue=5 |pages=2547–50 |date=May 2014 |pmid=24778074 |doi= |url=}}</ref><ref name="pmid247780742">{{cite journal |vauthors=Niazi AK, Kaley K, Saif MW |title=Gastrointestinal stromal tumor of colon: a case report and review of literature |journal=Anticancer Res. |volume=34 |issue=5 |pages=2547–50 |date=May 2014 |pmid=24778074 |doi= |url=}}</ref><ref name="pmid15223958">{{cite journal |vauthors=Medeiros F, Corless CL, Duensing A, Hornick JL, Oliveira AM, Heinrich MC, Fletcher JA, Fletcher CD |title=KIT-negative gastrointestinal stromal tumors: proof of concept and therapeutic implications |journal=Am. J. Surg. Pathol. |volume=28 |issue=7 |pages=889–94 |date=July 2004 |pmid=15223958 |doi= |url=}}</ref><ref name="pmid16222452">{{cite journal |vauthors=Kamiyama Y, Aihara R, Nakabayashi T, Mochiki E, Asao T, Kuwano H, Oriuchi N, Endo K |title=18F-fluorodeoxyglucose positron emission tomography: useful technique for predicting malignant potential of gastrointestinal stromal tumors |journal=World J Surg |volume=29 |issue=11 |pages=1429–35 |date=November 2005 |pmid=16222452 |doi=10.1007/s00268-005-0045-6 |url=}}</ref><ref name="pmid15613856">{{cite journal |vauthors=Miettinen M, Sobin LH, Lasota J |title=Gastrointestinal stromal tumors of the stomach: a clinicopathologic, immunohistochemical, and molecular genetic study of 1765 cases with long-term follow-up |journal=Am. J. Surg. Pathol. |volume=29 |issue=1 |pages=52–68 |date=January 2005 |pmid=15613856 |doi= |url=}}</ref> | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Gastrointestinal stromal tumor|Gastrointestinal Stromal Tumors (GIST)]]<ref name="pmid24778074">{{cite journal |vauthors=Niazi AK, Kaley K, Saif MW |title=Gastrointestinal stromal tumor of colon: a case report and review of literature |journal=Anticancer Res. |volume=34 |issue=5 |pages=2547–50 |date=May 2014 |pmid=24778074 |doi= |url=}}</ref><ref name="pmid247780742">{{cite journal |vauthors=Niazi AK, Kaley K, Saif MW |title=Gastrointestinal stromal tumor of colon: a case report and review of literature |journal=Anticancer Res. |volume=34 |issue=5 |pages=2547–50 |date=May 2014 |pmid=24778074 |doi= |url=}}</ref><ref name="pmid15223958">{{cite journal |vauthors=Medeiros F, Corless CL, Duensing A, Hornick JL, Oliveira AM, Heinrich MC, Fletcher JA, Fletcher CD |title=KIT-negative gastrointestinal stromal tumors: proof of concept and therapeutic implications |journal=Am. J. Surg. Pathol. |volume=28 |issue=7 |pages=889–94 |date=July 2004 |pmid=15223958 |doi= |url=}}</ref><ref name="pmid16222452">{{cite journal |vauthors=Kamiyama Y, Aihara R, Nakabayashi T, Mochiki E, Asao T, Kuwano H, Oriuchi N, Endo K |title=18F-fluorodeoxyglucose positron emission tomography: useful technique for predicting malignant potential of gastrointestinal stromal tumors |journal=World J Surg |volume=29 |issue=11 |pages=1429–35 |date=November 2005 |pmid=16222452 |doi=10.1007/s00268-005-0045-6 |url=}}</ref><ref name="pmid15613856">{{cite journal |vauthors=Miettinen M, Sobin LH, Lasota J |title=Gastrointestinal stromal tumors of the stomach: a clinicopathologic, immunohistochemical, and molecular genetic study of 1765 cases with long-term follow-up |journal=Am. J. Surg. Pathol. |volume=29 |issue=1 |pages=52–68 |date=January 2005 |pmid=15613856 |doi= |url=}}</ref> | ||
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*[[Epithelioid]] [[GIST|GISTs]] are rounded cells with oval nuclei and vesicular chromatin and appears nested | *[[Epithelioid]] [[GIST|GISTs]] are rounded cells with oval nuclei and vesicular chromatin and appears nested | ||
*On [[immunohistochemical staining]] they are positive for [[Molecular marker|molecular markers]] [[CD117]] antigen and KIT protein. | *On [[immunohistochemical staining]] they are positive for [[Molecular marker|molecular markers]] [[CD117]] antigen and KIT protein. | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" |Endoscopic ultrasound with [[biopsy]] and [[Histopathological|histopathological analysis]] | ||
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| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Hamartoma]]<ref name="pmid26672891">{{cite journal |vauthors=Cauchin E, Touchefeu Y, Matysiak-Budnik T |title=Hamartomatous Tumors in the Gastrointestinal Tract |journal=Gastrointest Tumors |volume=2 |issue=2 |pages=65–74 |date=September 2015 |pmid=26672891 |pmc=4668787 |doi=10.1159/000437175 |url=}}</ref> | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Hamartoma]]<ref name="pmid26672891">{{cite journal |vauthors=Cauchin E, Touchefeu Y, Matysiak-Budnik T |title=Hamartomatous Tumors in the Gastrointestinal Tract |journal=Gastrointest Tumors |volume=2 |issue=2 |pages=65–74 |date=September 2015 |pmid=26672891 |pmc=4668787 |doi=10.1159/000437175 |url=}}</ref> | ||
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* The nuclei are bland and mostly uniform, occasional larger nuclei are found. The cytoplasmic borders are indistinct | * The nuclei are bland and mostly uniform, occasional larger nuclei are found. The cytoplasmic borders are indistinct | ||
* Involvement of mucosa but never the submucosa | * Involvement of mucosa but never the submucosa | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" |[[Biopsy]] | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[MALT lymphoma|Colorectal Lymphoma]]<ref name="pmid20011310">{{cite journal |vauthors=Quayle FJ, Lowney JK |title=Colorectal lymphoma |journal=Clin Colon Rectal Surg |volume=19 |issue=2 |pages=49–53 |date=May 2006 |pmid=20011310 |pmc=2780105 |doi=10.1055/s-2006-942344 |url=}}</ref><ref name="QuayleLowney2006">{{cite journal|last1=Quayle|first1=Frank|last2=Lowney|first2=Jennifer|title=Colorectal Lymphoma|journal=Clinics in Colon and Rectal Surgery|volume=19|issue=2|year=2006|pages=049–053|issn=1531-0043|doi=10.1055/s-2006-942344}}</ref> | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[MALT lymphoma|Colorectal Lymphoma]]<ref name="pmid20011310">{{cite journal |vauthors=Quayle FJ, Lowney JK |title=Colorectal lymphoma |journal=Clin Colon Rectal Surg |volume=19 |issue=2 |pages=49–53 |date=May 2006 |pmid=20011310 |pmc=2780105 |doi=10.1055/s-2006-942344 |url=}}</ref><ref name="QuayleLowney2006">{{cite journal|last1=Quayle|first1=Frank|last2=Lowney|first2=Jennifer|title=Colorectal Lymphoma|journal=Clinics in Colon and Rectal Surgery|volume=19|issue=2|year=2006|pages=049–053|issn=1531-0043|doi=10.1055/s-2006-942344}}</ref> | ||
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* [[Follicular lymphoma]] | * [[Follicular lymphoma]] | ||
* | * | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" |[[Biopsy]] | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Kaposi's sarcoma]]<ref name="pmid20827371">{{cite journal |vauthors=Arora M, Goldberg EM |title=Kaposi sarcoma involving the gastrointestinal tract |journal=Gastroenterol Hepatol (N Y) |volume=6 |issue=7 |pages=459–62 |date=July 2010 |pmid=20827371 |pmc=2933764 |doi= |url=}}</ref> | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Kaposi's sarcoma]]<ref name="pmid20827371">{{cite journal |vauthors=Arora M, Goldberg EM |title=Kaposi sarcoma involving the gastrointestinal tract |journal=Gastroenterol Hepatol (N Y) |volume=6 |issue=7 |pages=459–62 |date=July 2010 |pmid=20827371 |pmc=2933764 |doi= |url=}}</ref> | ||
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* Premonitory sign (a neovascular lesion wrapped around a pre-existing space) | * Premonitory sign (a neovascular lesion wrapped around a pre-existing space) | ||
* Intracytoplasmic PAS +ve [[hyaline]] globules | * Intracytoplasmic PAS +ve [[hyaline]] globules | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" |Biopsy | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Arteriovenous malformation]]<ref name="pmid28139503">{{cite journal |vauthors=Lee HH, Kwon HM, Gil S, Kim YS, Cho M, Seo KJ, Chae HS, Cho YS |title=Endoscopic resection of asymptomatic, colonic, polypoid arteriovenous malformations: Two case reports and a literature review |journal=Saudi J Gastroenterol |volume=23 |issue=1 |pages=67–70 |date=2017 |pmid=28139503 |pmc=5329980 |doi=10.4103/1319-3767.199111 |url=}}</ref> | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Arteriovenous malformation]]<ref name="pmid28139503">{{cite journal |vauthors=Lee HH, Kwon HM, Gil S, Kim YS, Cho M, Seo KJ, Chae HS, Cho YS |title=Endoscopic resection of asymptomatic, colonic, polypoid arteriovenous malformations: Two case reports and a literature review |journal=Saudi J Gastroenterol |volume=23 |issue=1 |pages=67–70 |date=2017 |pmid=28139503 |pmc=5329980 |doi=10.4103/1319-3767.199111 |url=}}</ref> | ||
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* Aberrant vessels with thickened, hypertrophic walls in the mucosa and the submucosa. | * Aberrant vessels with thickened, hypertrophic walls in the mucosa and the submucosa. | ||
* Arteries directly connected to veins without capillary beds | * Arteries directly connected to veins without capillary beds | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" |Accidental finding | ||
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| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Diverticular disease|Diverticular diseases]]<ref name="pmid16187597">{{cite journal |vauthors=Shen SH, Chen JD, Tiu CM, Chou YH, Chiang JH, Chang CY, Lee CH |title=Differentiating colonic diverticulitis from colon cancer: the value of computed tomography in the emergency setting |journal=J Chin Med Assoc |volume=68 |issue=9 |pages=411–8 |date=September 2005 |pmid=16187597 |doi=10.1016/S1726-4901(09)70156-X |url=}}</ref><ref name="ShenChen2005">{{cite journal|last1=Shen|first1=Shu-Huei|last2=Chen|first2=Jen-Dar|last3=Tiu|first3=Chui-Mei|last4=Chou|first4=Yi-Hong|last5=Chiang|first5=Jen-Huei|last6=Chang|first6=Cheng-Yen|last7=Lee|first7=Chen-Hsen|title=Differentiating Colonic Diverticulitis from Colon Cancer: The Value of Computed Tomography in the Emergency Setting|journal=Journal of the Chinese Medical Association|volume=68|issue=9|year=2005|pages=411–418|issn=17264901|doi=10.1016/S1726-4901(09)70156-X}}</ref><ref name="SheimanLevine20082">{{cite journal|last1=Sheiman|first1=Laura|last2=Levine|first2=Marc S.|last3=Levin|first3=Alicia A.|last4=Hogan|first4=Jonathan|last5=Rubesin|first5=Stephen E.|last6=Furth|first6=Emma E.|last7=Laufer|first7=Igor|title=Chronic Diverticulitis: Clinical, Radiographic, and Pathologic Findings|journal=American Journal of Roentgenology|volume=191|issue=2|year=2008|pages=522–528|issn=0361-803X|doi=10.2214/AJR.07.3597}}</ref> | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Diverticular disease|Diverticular diseases]]<ref name="pmid16187597">{{cite journal |vauthors=Shen SH, Chen JD, Tiu CM, Chou YH, Chiang JH, Chang CY, Lee CH |title=Differentiating colonic diverticulitis from colon cancer: the value of computed tomography in the emergency setting |journal=J Chin Med Assoc |volume=68 |issue=9 |pages=411–8 |date=September 2005 |pmid=16187597 |doi=10.1016/S1726-4901(09)70156-X |url=}}</ref><ref name="ShenChen2005">{{cite journal|last1=Shen|first1=Shu-Huei|last2=Chen|first2=Jen-Dar|last3=Tiu|first3=Chui-Mei|last4=Chou|first4=Yi-Hong|last5=Chiang|first5=Jen-Huei|last6=Chang|first6=Cheng-Yen|last7=Lee|first7=Chen-Hsen|title=Differentiating Colonic Diverticulitis from Colon Cancer: The Value of Computed Tomography in the Emergency Setting|journal=Journal of the Chinese Medical Association|volume=68|issue=9|year=2005|pages=411–418|issn=17264901|doi=10.1016/S1726-4901(09)70156-X}}</ref><ref name="SheimanLevine20082">{{cite journal|last1=Sheiman|first1=Laura|last2=Levine|first2=Marc S.|last3=Levin|first3=Alicia A.|last4=Hogan|first4=Jonathan|last5=Rubesin|first5=Stephen E.|last6=Furth|first6=Emma E.|last7=Laufer|first7=Igor|title=Chronic Diverticulitis: Clinical, Radiographic, and Pathologic Findings|journal=American Journal of Roentgenology|volume=191|issue=2|year=2008|pages=522–528|issn=0361-803X|doi=10.2214/AJR.07.3597}}</ref> | ||
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| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
* N/A | * N/A | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" |CT scan | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Hemorrhoids]]<ref name="JacobsSolomon2014">{{cite journal|last1=Jacobs|first1=Danny|last2=Solomon|first2=Caren G.|title=Hemorrhoids|journal=New England Journal of Medicine|volume=371|issue=10|year=2014|pages=944–951|issn=0028-4793|doi=10.1056/NEJMcp1204188}}</ref> | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Hemorrhoids]]<ref name="JacobsSolomon2014">{{cite journal|last1=Jacobs|first1=Danny|last2=Solomon|first2=Caren G.|title=Hemorrhoids|journal=New England Journal of Medicine|volume=371|issue=10|year=2014|pages=944–951|issn=0028-4793|doi=10.1056/NEJMcp1204188}}</ref> | ||
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| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
* N/A | * N/A | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" |Clinical | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Anal fissure]]<ref name="pmid27041801">{{cite journal |vauthors=Schlichtemeier S, Engel A |title=Anal fissure |journal=Aust Prescr |volume=39 |issue=1 |pages=14–7 |year=2016 |pmid=27041801 |pmc=4816871 |doi=10.18773/austprescr.2016.007 |url=}}</ref> | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Anal fissure]]<ref name="pmid27041801">{{cite journal |vauthors=Schlichtemeier S, Engel A |title=Anal fissure |journal=Aust Prescr |volume=39 |issue=1 |pages=14–7 |year=2016 |pmid=27041801 |pmc=4816871 |doi=10.18773/austprescr.2016.007 |url=}}</ref> | ||
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| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
* N/A | * N/A | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" |Clinical | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Infectious colitis]]<ref name="pmid22080825">{{cite journal |vauthors=DuPont HL |title=Approach to the patient with infectious colitis |journal=Curr. Opin. Gastroenterol. |volume=28 |issue=1 |pages=39–46 |date=January 2012 |pmid=22080825 |doi=10.1097/MOG.0b013e32834d3208 |url=}}</ref> | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Infectious colitis]]<ref name="pmid22080825">{{cite journal |vauthors=DuPont HL |title=Approach to the patient with infectious colitis |journal=Curr. Opin. Gastroenterol. |volume=28 |issue=1 |pages=39–46 |date=January 2012 |pmid=22080825 |doi=10.1097/MOG.0b013e32834d3208 |url=}}</ref> | ||
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| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
* N/A | * N/A | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" |Stool culture | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Ulcerative colitis]]<ref name="pmid25075198">{{cite journal |vauthors=Fakhoury M, Negrulj R, Mooranian A, Al-Salami H |title=Inflammatory bowel disease: clinical aspects and treatments |journal=J Inflamm Res |volume=7 |issue= |pages=113–20 |date=2014 |pmid=25075198 |pmc=4106026 |doi=10.2147/JIR.S65979 |url=}}</ref> | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Ulcerative colitis]]<ref name="pmid25075198">{{cite journal |vauthors=Fakhoury M, Negrulj R, Mooranian A, Al-Salami H |title=Inflammatory bowel disease: clinical aspects and treatments |journal=J Inflamm Res |volume=7 |issue= |pages=113–20 |date=2014 |pmid=25075198 |pmc=4106026 |doi=10.2147/JIR.S65979 |url=}}</ref> | ||
Line 488: | Line 470: | ||
* Distorted crypts | * Distorted crypts | ||
* Crypt abscess | * Crypt abscess | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" |Endoscopy and a mucosal biopsy<ref name="pmid16902215">{{cite journal |vauthors=Collins P, Rhodes J |title=Ulcerative colitis: diagnosis and management |journal=BMJ |volume=333 |issue=7563 |pages=340–3 |date=August 2006 |pmid=16902215 |pmc=1539087 |doi=10.1136/bmj.333.7563.340 |url=}}</ref> | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Crohn's disease]]<ref name="pmid25075198">{{cite journal |vauthors=Fakhoury M, Negrulj R, Mooranian A, Al-Salami H |title=Inflammatory bowel disease: clinical aspects and treatments |journal=J Inflamm Res |volume=7 |issue= |pages=113–20 |date=2014 |pmid=25075198 |pmc=4106026 |doi=10.2147/JIR.S65979 |url=}}</ref> | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Crohn's disease]]<ref name="pmid25075198">{{cite journal |vauthors=Fakhoury M, Negrulj R, Mooranian A, Al-Salami H |title=Inflammatory bowel disease: clinical aspects and treatments |journal=J Inflamm Res |volume=7 |issue= |pages=113–20 |date=2014 |pmid=25075198 |pmc=4106026 |doi=10.2147/JIR.S65979 |url=}}</ref> | ||
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* Focal infiltration of leukocytes into the epithelium | * Focal infiltration of leukocytes into the epithelium | ||
* Granulomas | * Granulomas | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" |Endoscopy and a mucosal biopsy | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Irritable bowel syndrome]]<ref name="pmid28875974">{{cite journal |vauthors=Iwańczak B, Iwańczak F |title=[Functional gastrointestinal disorders in children and adolescents. The Rome IV criteria] |language=Polish |journal=Pol. Merkur. Lekarski |volume=43 |issue=254 |pages=75–82 |date=August 2017 |pmid=28875974 |doi= |url=}}</ref> | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Irritable bowel syndrome]]<ref name="pmid28875974">{{cite journal |vauthors=Iwańczak B, Iwańczak F |title=[Functional gastrointestinal disorders in children and adolescents. The Rome IV criteria] |language=Polish |journal=Pol. Merkur. Lekarski |volume=43 |issue=254 |pages=75–82 |date=August 2017 |pmid=28875974 |doi= |url=}}</ref> | ||
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| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
* N/A | * N/A | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" |Clinical diagnosis ([[Irritable bowel syndrome Diagnostic Study of Choice|Rome criteria]]) | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Appendicitis]]<ref name="pmid14616200">{{cite journal |vauthors=Choi D, Park H, Lee YR, Kook SH, Kim SK, Kwag HJ, Chung EC |title=The most useful findings for diagnosing acute appendicitis on contrast-enhanced helical CT |journal=Acta Radiol |volume=44 |issue=6 |pages=574–82 |year=2003 |pmid=14616200 |doi= |url=}}</ref> | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Appendicitis]]<ref name="pmid14616200">{{cite journal |vauthors=Choi D, Park H, Lee YR, Kook SH, Kim SK, Kwag HJ, Chung EC |title=The most useful findings for diagnosing acute appendicitis on contrast-enhanced helical CT |journal=Acta Radiol |volume=44 |issue=6 |pages=574–82 |year=2003 |pmid=14616200 |doi= |url=}}</ref> | ||
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| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
* N/A | * N/A | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" |[[Computed tomography|CT scan]] | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Strangulated hernia]] | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Strangulated hernia]] | ||
Line 604: | Line 582: | ||
* Lateral crescent sign | * Lateral crescent sign | ||
* The hernia neck will be superolateral to the course of the inferior [[epigastric]] vessels. | * The hernia neck will be superolateral to the course of the inferior [[epigastric]] vessels. | ||
* Ultrasound: | |||
** Hypoechoic mass suggesting dilated and edematous intestinal segment | |||
* | * | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
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| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
* N/A | * N/A | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" |Ultrasound | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Endometriosis|Bowel endometriosis]]<ref name="pmid25400445">{{cite journal |vauthors=Wolthuis AM, Meuleman C, Tomassetti C, D'Hooghe T, de Buck van Overstraeten A, D'Hoore A |title=Bowel endometriosis: colorectal surgeon's perspective in a multidisciplinary surgical team |journal=World J. Gastroenterol. |volume=20 |issue=42 |pages=15616–23 |date=November 2014 |pmid=25400445 |pmc=4229526 |doi=10.3748/wjg.v20.i42.15616 |url=}}</ref> | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Endometriosis|Bowel endometriosis]]<ref name="pmid25400445">{{cite journal |vauthors=Wolthuis AM, Meuleman C, Tomassetti C, D'Hooghe T, de Buck van Overstraeten A, D'Hoore A |title=Bowel endometriosis: colorectal surgeon's perspective in a multidisciplinary surgical team |journal=World J. Gastroenterol. |volume=20 |issue=42 |pages=15616–23 |date=November 2014 |pmid=25400445 |pmc=4229526 |doi=10.3748/wjg.v20.i42.15616 |url=}}</ref> | ||
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| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
* N/A | * N/A | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" |Transvaginal ultrasonography | ||
|} | |} | ||
Revision as of 17:01, 25 January 2019
Colorectal cancer Microchapters |
Diagnosis |
---|
Treatment |
Case Studies |
Colorectal cancer differential diagnosis On the Web |
American Roentgen Ray Society Images of Colorectal cancer differential diagnosis |
Risk calculators and risk factors for Colorectal cancer differential diagnosis |
To view the differential diagnosis of familial adenomatous polyposis (FAP), click here
To view the differential diagnosis of hereditary nonpolyposis colorectal cancer (HNPCC), click here
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]: Associate Editor(s)-in-Chief: Trusha Tank, M.D.[2], Qurrat-ul-ain Abid, M.D.[3]
Overview
Colorectal cancer must be differentiated from other diseases that cause unexplained weight loss, unexplained loss of appetite, nausea, vomiting, diarrhea, anemia, jaundice, and fatigue, such as irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), hemorrhoids, anal fissures, and diverticular disease. There are less common conditions that may be confused as colorectal cancer such as infectious colitis and gastrointestinal lymphoma.
Colorectal Cancer Differential Diagnosis
- Colorectal cancer must be differentiated from other diseases that cause lower abdominal pain and fever like appendicitis, diverticulitis, inflammatory bowel disease, cystitis, and endometritis.[1][2][3][4][5][6]
Other conditions that can be mistaken for colorectal cancer include the following:
- Benign colon polyps
- Ischemic colitis
- Infectious colitis
- Arteriovenous malformation (AVM)
- Carcinoid/neuroendocrine tumors
- Small intestine carcinomas
- Gastrointestinal lymphoma
- Ileus
- Pregnancy
- Appendicitis
- Hernia
- Lactose intolerance
- Flatulence
- Ulcer
- Cholecystitis
Diseases | Clinical manifestations | Para-clinical findings | Gold standard | |||||||
---|---|---|---|---|---|---|---|---|---|---|
Symptoms | ||||||||||
Lab Findings | Imaging | Histopathology | ||||||||
Constipation/ Diarrhea |
Blood in stool | Abdominal pain | Other symptoms | Anemia | Colonoscopy | CT scan | Other diagnostic study | |||
Adenocarcinoma[7] |
and/or |
+ |
|
+ |
|
|
|
|
Biopsy and histopathological analysis | |
Peutz-Jeghers syndrome [8][9][10][11][12] |
and/or |
+ |
|
|
+ |
|
|
Genetic testing for STK11 and colonoscopy | ||
Carcinoids [13][14][15][16][17] |
+/- |
|
+ |
|
|
|
|
Biopsy and histopathological analysis | ||
Juvenile Polyposis Coli[18][19][20][21][22] | + |
|
|
+ |
|
|
|
Diagnostic criteria on the basis of history, colonoscopy, and genetics | ||
Gastrointestinal Stromal Tumors (GIST)[23][24][25][26][27] |
|
+/- |
|
|
+/- |
|
|
|
|
Endoscopic ultrasound with biopsy and histopathological analysis |
Hamartoma[30] | + |
|
- |
|
|
|
|
Biopsy | ||
Colorectal Lymphoma[31][32] |
|
+/- |
|
|
+ |
|
|
|
Biopsy | |
Kaposi's sarcoma[33] | + |
|
+ |
|
|
|
|
Biopsy | ||
Arteriovenous malformation[34] |
|
+ |
|
|
+ |
|
|
|
|
Accidental finding |
Diverticular diseases[35][36][37] |
and/or |
+/- |
|
- |
|
|
|
|
CT scan | |
Hemorrhoids[38] | + |
|
|
+ |
|
|
|
Clinical | ||
Anal fissure[39] |
|
+ |
|
|
+/- |
|
|
|
|
Clinical |
Infectious colitis[40] | + |
|
- |
|
|
|
|
Stool culture | ||
Ulcerative colitis[41] | + |
|
|
+ |
|
|
|
|
Endoscopy and a mucosal biopsy[42] | |
Crohn's disease[41] | + |
|
+ |
|
|
|
|
Endoscopy and a mucosal biopsy | ||
Irritable bowel syndrome[43] |
and/or |
+ |
|
|
- |
|
|
|
|
Clinical diagnosis (Rome criteria) |
Appendicitis[44] | - |
|
|
- |
|
|
|
|
CT scan | |
Strangulated hernia |
|
- |
|
N/V
Heaviness or dull discomfort in the groin, with straining, lifting, coughing, or exercising Weakness, heaviness, burning, or aching in the groin Pain and swelling |
- |
|
|
|
|
Ultrasound |
Bowel endometriosis[45] |
and/or |
+ |
|
|
+ |
|
|
|
|
Transvaginal ultrasonography |
References
- ↑ Laurell H, Hansson LE, Gunnarsson U (2007). "Acute diverticulitis--clinical presentation and differential diagnostics". Colorectal Dis. 9 (6): 496–501, discussion 501-2. doi:10.1111/j.1463-1318.2006.01162.x. PMID 17573742.
- ↑ Hardin, M. Acute Appendicitis: Review and Update. Am Fam Physician".1999, Nov 1;60(7):2027-2034
- ↑ Hanauer SB (1996). "Inflammatory bowel disease". N Engl J Med. 334 (13): 841–8. doi:10.1056/NEJM199603283341307. PMID 8596552.
- ↑ Cystitis-acute. MedlinePlus.https://www.nlm.nih.gov/medlineplus/ency/article/000526.htm Accessed on February 9, 2016
- ↑ Prostatitis - bacterial. NLM Medline Plus 2016. https://www.nlm.nih.gov/medlineplus/ency/article/000519.htm. Accessed on March 2, 2016
- ↑ Ford GW, Decker CF (2016). "Pelvic inflammatory disease". Dis Mon. 62 (8): 301–5. doi:10.1016/j.disamonth.2016.03.015. PMID 27107781.
- ↑ Secco GB, Fardelli R, Campora E, Lapertosa G, Gentile R, Zoli S, Prior C (1994). "Primary mucinous adenocarcinomas and signet-ring cell carcinomas of colon and rectum". Oncology. 51 (1): 30–4. doi:10.1159/000227306. PMID 8265100.
- ↑ Zhong ME, Niu BZ, Ji WY, Wu B (June 2016). "Laparoscopic restorative proctocolectomy with ileal pouch-anal anastomosis for Peutz-Jeghers syndrome with synchronous rectal cancer". World J. Gastroenterol. 22 (22): 5293–6. doi:10.3748/wjg.v22.i22.5293. PMID 27298573.
- ↑ Kopacova, Marcela; Tacheci, Ilja; Rejchrt, Stanislav; Bures, Jan (2009). "Peutz-Jeghers syndrome: Diagnostic and therapeuticapproach". World Journal of Gastroenterology. 15 (43): 5397. doi:10.3748/wjg.15.5397. ISSN 1007-9327.
- ↑ Giardiello, F; Trimbath, J (2006). "Peutz-Jeghers Syndrome and Management Recommendations". Clinical Gastroenterology and Hepatology. 4 (4): 408–415. doi:10.1016/j.cgh.2005.11.005. ISSN 1542-3565.
- ↑ Beggs, A. D.; Latchford, A. R.; Vasen, H. F. A.; Moslein, G.; Alonso, A.; Aretz, S.; Bertario, L.; Blanco, I.; Bulow, S.; Burn, J.; Capella, G.; Colas, C.; Friedl, W.; Moller, P.; Hes, F. J.; Jarvinen, H.; Mecklin, J.-P.; Nagengast, F. M.; Parc, Y.; Phillips, R. K. S.; Hyer, W.; Ponz de Leon, M.; Renkonen-Sinisalo, L.; Sampson, J. R.; Stormorken, A.; Tejpar, S.; Thomas, H. J. W.; Wijnen, J. T.; Clark, S. K.; Hodgson, S. V. (2010). "Peutz-Jeghers syndrome: a systematic review and recommendations for management". Gut. 59 (7): 975–986. doi:10.1136/gut.2009.198499. ISSN 0017-5749.
- ↑ Kopacova, Marcela; Tacheci, Ilja; Rejchrt, Stanislav; Bures, Jan (2009). "Peutz-Jeghers syndrome: Diagnostic and therapeuticapproach". World Journal of Gastroenterology. 15 (43): 5397. doi:10.3748/wjg.15.5397. ISSN 1007-9327.
- ↑ Chung TP, Hunt SR (May 2006). "Carcinoid and neuroendocrine tumors of the colon and rectum". Clin Colon Rectal Surg. 19 (2): 45–8. doi:10.1055/s-2006-942343. PMC 2780103. PMID 20011309.
- ↑ Diagnostics: Biochemical Markers, Imaging, and Approach. National cancer institute. http://www.cancer.gov/types/gi-carcinoid-tumors/hp/gi-carcinoid-treatment-pdq
- ↑ Rindi G, Falconi M, Klersy C, Albarello L, Boninsegna L, Buchler MW, Capella C, Caplin M, Couvelard A, Doglioni C, Delle Fave G, Fischer L, Fusai G, de Herder WW, Jann H, Komminoth P, de Krijger RR, La Rosa S, Luong TV, Pape U, Perren A, Ruszniewski P, Scarpa A, Schmitt A, Solcia E, Wiedenmann B (May 2012). "TNM staging of neoplasms of the endocrine pancreas: results from a large international cohort study". J. Natl. Cancer Inst. 104 (10): 764–77. doi:10.1093/jnci/djs208. PMID 22525418.
- ↑ Fang C, Wang W, Zhang Y, Feng X, Sun J, Zeng Y, Chen Y, Li Y, Chen M, Zhou Z, Chen J (June 2017). "Clinicopathologic characteristics and prognosis of gastroenteropancreatic neuroendocrine neoplasms: a multicenter study in South China". Chin J Cancer. 36 (1): 51. doi:10.1186/s40880-017-0218-3. PMC 5480192. PMID 28637502.
- ↑ Signs and symptoms of carcinoid syndrome. National Cancer Institute. http://www.cancer.gov/types/gi-carcinoid-tumors/patient/gi-carcinoid-treatment-pdq
- ↑ Grotsky HW, Rickert RR, Smith WD, Newsome JF (March 1982). "Familial juvenile polyposis coli. A clinical and pathologic study of a large kindred". Gastroenterology. 82 (3): 494–501. PMID 7054044.
- ↑ Brosens LA, Langeveld D, van Hattem WA, Giardiello FM, Offerhaus GJ (November 2011). "Juvenile polyposis syndrome". World J. Gastroenterol. 17 (44): 4839–44. doi:10.3748/wjg.v17.i44.4839. PMC 3235625. PMID 22171123.
- ↑ Latchford AR, Neale K, Phillips RK, Clark SK (October 2012). "Juvenile polyposis syndrome: a study of genotype, phenotype, and long-term outcome". Dis. Colon Rectum. 55 (10): 1038–43. doi:10.1097/DCR.0b013e31826278b3. PMID 22965402.
- ↑ Latchford AR, Neale K, Phillips RK, Clark SK (October 2012). "Juvenile polyposis syndrome: a study of genotype, phenotype, and long-term outcome". Dis. Colon Rectum. 55 (10): 1038–43. doi:10.1097/DCR.0b013e31826278b3. PMID 22965402.
- ↑ Latchford AR, Neale K, Phillips RK, Clark SK (October 2012). "Juvenile polyposis syndrome: a study of genotype, phenotype, and long-term outcome". Dis. Colon Rectum. 55 (10): 1038–43. doi:10.1097/DCR.0b013e31826278b3. PMID 22965402.
- ↑ Niazi AK, Kaley K, Saif MW (May 2014). "Gastrointestinal stromal tumor of colon: a case report and review of literature". Anticancer Res. 34 (5): 2547–50. PMID 24778074.
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