Surgical pathology report
Pathological diagnosis :
1. adenocarcinoma, moderately differentiated, of colon.
2. the tumor focally involved the entire thickness of muscular layer.
3. the tumor also invaded subserosal layer but did not involve serosa.
4. presence of lymphovascular invasion.
5. appendix : no pathological alteration.
6. surgical resection ends; proximal and distal : free of tumor.
7. regional lymph nodes; no evidence of metastasis in all 20 examined nodes.
Macroscopic examination :
1. the specimen consists of a colonic segment measuring 4.5 cm. in length and includes the cecum, vermiform appendix, and a 4 cm. segment of terminal ileum.
Opening specimen reveals fun gating ulcerted mass, measuring 1.4 cm. involving entire circumference. it situates at 15.5 cm. from colonic end. cut sections reveal whitish gray tissue invading into subserosa. satellite mucosal polyps are not present. mucosal surface of the ileum is unremarkable. representative sections are submitted as a-b = margin, c= appendix, d-h = mass, i-p = lymph nodes
2. the specimen consists of a previously opened gallbladder, measuring 5x3.5x3 cm. the external surface is hyperemic. the wall measures 0.2 up to 0.3 cm thick. the mucosa is poorly velvety. representative sections are taken as Q-R.
Microscopic examination
1. Sections of mass lesion at colon compose of solid nests as well as glandular structures. Those tumor cells are large round as well as cuboidal cells. Those tumor cells contain enlarged hyperchromatic nuclei, containing nucleoli. Mitotic figures are occasionally observed. Focal necrosis of tumor cells are also observed.
- The tumor focally involved the entire thickness of muscular layer.
- The tumor also invaded subserosal layer but did not involve serosa
- Lymph vascular invasions are noted.
- Sections of the appendix show normal mucosa and sub mucosal lymphoid follicles. No definite inflammatory process or malignancy is seen.
- Both proximal and distal surgical resection ends are free of tumor.
- Sections of all 20 regional lymph nodes reveal no evidence of metastasis.
2. Sections of the gall bladder reveal thickening of its wall due to edematous change. Focal shortening of the mucosal folds infiltrated by minimal number of chronic inflammatory cells in their cores are noted. The muscular layers are also infiltrated by minimal number of chronic inflammatory cells