A 68-year-old man with a 20-year history of Crohn's disease presents with progressive weight loss and diarrhea. Vital signs show BP 128/76, HR 92, RR 18, Temp 37.2°C, SpO2 98%. Colonoscopy reveals a 3-cm ulcerated mass in the terminal ileum with adjacent high-grade dysplasia; no perforations noted. CT abdomen shows focal wall thickening without distant metastases. Histopathology demonstrates adenocarcinoma. Hemoglobin is 10.2 g/dL. Which pathogenic sequence best explains this malignancy development?
- A)Viral integration → oncogene activation → direct transformation
- B)Aberrant Wnt signaling → loss of APC → polyp formation → carcinoma
- C)Dietary carcinogens → direct DNA adduct formation → mutation
- D)Bacterial translocation → epithelial apoptosis → dysplasia → carcinoma
- E)Chronic inflammation → mucosal injury → dysplasia → carcinomaGABARITO
Explicação
Chronic inflammatory bowel disease causes repeated cycles of mucosal injury and inflammation, leading to dysplasia and eventually adenocarcinoma. This is the inflammation-dysplasia-carcinoma sequence. Ver explicação completa e trilha adaptativa →