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A #PathQuiz on the #CAPProtocol of cancers of the anus
#pathology #GIPath
1. According to WHO, squamous cell carcinoma (SCC) of the anus should be subtyped as: large cell keratinizing, large cell non-keratinizing & basaloid.
#pathology #GIPath
1. According to WHO, squamous cell carcinoma (SCC) of the anus should be subtyped as: large cell keratinizing, large cell non-keratinizing & basaloid.
False
Before, yes they would, but not anymore.
The WHO now recommends only to use the term SCC
Before, yes they would, but not anymore.
The WHO now recommends only to use the term SCC
2. Which morphology of SCC of the anus has the highest risk of distant metastasis?
Basaloid SCC has the highest risk of distant metastasis
3. The first line of treatment for anal cancers is surgery
False
Most anal cancers are successfully managed with chemotherapy & radiotherapy.
Most anal cancers are successfully managed with chemotherapy & radiotherapy.
4. If the entire tumor is visible by “gentle traction” on the buttock, it should be classified as a tumor of which site
Perianal region
Tumors of the anal canal CANNOT be completely visualized by traction.
Tumors arising on the skin or distal to the mucocutaneous junction are “perianal” BUT they should be within 5cm of the anus (close by)
Tumors of the anal canal CANNOT be completely visualized by traction.
Tumors arising on the skin or distal to the mucocutaneous junction are “perianal” BUT they should be within 5cm of the anus (close by)
5. Verrucous carcinoma (giant condyloma or Buschke-Lowenstein tumor) usually responds to conservative treatment.
False
The difference between verrucous carcinoma (VC) and a condyloma is that the latter can be managed conservatively (topical treatment).
VC need surgical excision with good margins and are notorious for local recurrences
The difference between verrucous carcinoma (VC) and a condyloma is that the latter can be managed conservatively (topical treatment).
VC need surgical excision with good margins and are notorious for local recurrences
6. Verrucous carcinomas are associated with
HPV6 & HPV11
SCC is usually associated with HPV16
SCC is usually associated with HPV16
7. A variant of SCC in the anal canal, SCC with mucinous microcysts (mucoepidermoid carcinoma), has a better prognosis than the usual SCC
False
They behave worse than the usual SCC’s and that’s why they need to be identified.
They behave worse than the usual SCC’s and that’s why they need to be identified.
8. If an anal canal tumor infiltrates the muscularis propria it is staged as a pT2.
False
Anal canals are staged according to their SIZE not the depth of infiltration.
Anal canals are staged according to their SIZE not the depth of infiltration.
9. Squamous cell carcinoma (SCC) of the anal canal are POSITIVE for
CK7
SCC of the anal canal express
CK7
CK5/6
p53 and p63
but are negative for CK20
SCC of the anal canal express
CK7
CK5/6
p53 and p63
but are negative for CK20
10. Anal gland carcinomas are POSITIVE for
Both CK7 & CK20
11. Which immunostain is helpful in differentiating primary versus secondary Paget cells involving the anal and perianal epithelium?
All of the above
CK7- Primary anal
CK20- Paget’s associated with rectal adenocarcinoma
GCDFP- can represent primary cutaneous intraepithelial malignancy
CK7- Primary anal
CK20- Paget’s associated with rectal adenocarcinoma
GCDFP- can represent primary cutaneous intraepithelial malignancy
And here's a quick recap!
