IPLab:Lab 7:Adenocarcinoma: Difference between revisions - Pathology Education Instructional Resource

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== Clinical Summary ==

Approximately four months prior to admission, this 68-year-old male began having "sharp, shooting pains" in the lower abdomen. ~~A barium enema at that time was reported as normal. Two months later, the barium study was repeated because of persistent diarrhea and~~ showed a ~~filling defect~~ in the transverse colon. The patient refused to undergo ~~an exploratory~~ laparotomy. ~~During the week prior to this admission, the patient had recurrent diarrhea, cramping~~ abdominal pain, and ~~marked rectal bleeding. He was hospitalized and required 2500 ml of blood to return his hematocrit to normal. A~~ colectomy was ~~done from the hepatic flexure to the rectosigmoid~~.

Approximately four months prior to admission, this 68-year-old male began having "sharp, shooting pains" in the lower abdomen. On admission a CT scan showed a mass in the transverse colon. The patient refused to undergo a laparotomy and declined further treatment. Six months later he returned with severe abdominal pain and a colectomy was performed.

~~== Autopsy Findings ==~~

The segment of colon contained numerous polyps and an annular tumor which was 6.7 cm in diameter. Endoscopic examination of the ascending colon revealed two more polyps which were removed.

The segment of colon contained numerous polyps and an annular tumor which was 6.7 cm in diameter. ~~Proctoscopic~~ examination of the ascending colon revealed two more polyps which were removed.

== Images ==

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File:IPLab7ColonCA9.jpg|This is a segment of distal colon from another case. Note the annular tumor that severely compromises the lumen of the colon. There is dilation of the colon proximal to the tumor.

</gallery>

== Virtual Microscopy ==

<peir-vm>IPLab7ColonCA</peir-vm>

== Study Questions ==

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=== Journal Articles ===

* Yuen ST, Wong MP, Chung LP, Chan SY, Cheung N, Ho J, Leung SY. [http://www.ncbi.nlm.nih.gov/pubmed/9543668 Up-regulation of lysozyme production in colonic adenomas and adenocarcinomas]. ''Histopathology'' 1998 Feb;32(2):126-32.

* Strum WB. [http://www.nejm.org/doi/full/10.1056/NEJMra1513581 Colorectal Adenomas]. ''NEJM'' 2016 March 17 374:1065-1075.

=== Images ===

@@ Line 1: / Line 1: @@
 == Clinical Summary ==
-Approximately four months prior to admission, this 68-year-old male began having "sharp, shooting pains" in the lower abdomen. A barium enema at that time was reported as normal. Two months later, the barium study was repeated because of persistent diarrhea and showed a filling defect in the transverse colon. The patient refused to undergo an exploratory laparotomy. During the week prior to this admission, the patient had recurrent diarrhea, cramping abdominal pain, and marked rectal bleeding. He was hospitalized and required 2500 ml of blood to return his hematocrit to normal. A colectomy was done from the hepatic flexure to the rectosigmoid.
+Approximately four months prior to admission, this 68-year-old male began having "sharp, shooting pains" in the lower abdomen.  On admission a CT scan showed a mass in the transverse colon. The patient refused to undergo a laparotomy and declined further treatment.  Six months later he returned with severe abdominal pain and a colectomy was performed.
-== Autopsy Findings ==
+The segment of colon contained numerous polyps and an annular tumor which was 6.7 cm in diameter. Endoscopic examination of the ascending colon revealed two more polyps which were removed.
-The segment of colon contained numerous polyps and an annular tumor which was 6.7 cm in diameter. Proctoscopic examination of the ascending colon revealed two more polyps which were removed.
 == Images ==
@@ Line 17: / Line 16: @@
 File:IPLab7ColonCA9.jpg|This is a segment of distal colon from another case. Note the annular tumor that severely compromises the lumen of the colon. There is dilation of the colon proximal to the tumor.
 </gallery>
+== Virtual Microscopy ==
+<peir-vm>IPLab7ColonCA</peir-vm>
 == Study Questions ==
@@ Line 37: / Line 39: @@
 === Journal Articles ===
 * Yuen ST, Wong MP, Chung LP, Chan SY, Cheung N, Ho J, Leung SY.  [http://www.ncbi.nlm.nih.gov/pubmed/9543668 Up-regulation of lysozyme production in colonic adenomas and adenocarcinomas].  ''Histopathology'' 1998 Feb;32(2):126-32.
+* Strum WB.  [http://www.nejm.org/doi/full/10.1056/NEJMra1513581 Colorectal Adenomas].  ''NEJM'' 2016 March 17 374:1065-1075.
 === Images ===