Difference between revisions of "IPLab:Lab 7:Adenocarcinoma"

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(Autopsy Findings)
 
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== Clinical Summary ==  
 
== 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.
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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 ==
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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 ==
 
== 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.  
 
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>
 
</gallery>
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== Virtual Microscopy ==
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<peir-vm>IPLab7ColonCA</peir-vm>
  
 
== Study Questions ==
 
== Study Questions ==
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# decreased intake of protective vitamins.
 
# decreased intake of protective vitamins.
 
It is thought that reduced fiber content leads to decreased stool bulk, increased fecal transit time in the bowel, and an altered bacterial flora of the intestine. Potentially toxic oxidative byproducts of carbohydrate degradation by bacteria are therefore present in higher concentrations in the small stools and are held in contact with the colonic mucosa for longer periods of time. More recent epidemiologic data have raised some doubt about the importance of fiber in the diet but most nutritionalists still recommend high fiber diet to help prevent colon cancer. Moreover, high fat intake enhances the synthesis of cholesterol and bile acids by the liver, which in turn may be converted into potential carcinogens by intestinal bacteria. Refined diets also contain less vitamins A, C, and E, which may act as oxygen radical scavengers.</spoiler>
 
It is thought that reduced fiber content leads to decreased stool bulk, increased fecal transit time in the bowel, and an altered bacterial flora of the intestine. Potentially toxic oxidative byproducts of carbohydrate degradation by bacteria are therefore present in higher concentrations in the small stools and are held in contact with the colonic mucosa for longer periods of time. More recent epidemiologic data have raised some doubt about the importance of fiber in the diet but most nutritionalists still recommend high fiber diet to help prevent colon cancer. Moreover, high fat intake enhances the synthesis of cholesterol and bile acids by the liver, which in turn may be converted into potential carcinogens by intestinal bacteria. Refined diets also contain less vitamins A, C, and E, which may act as oxygen radical scavengers.</spoiler>
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== Additional Resources ==
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=== Reference ===
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* [http://emedicine.medscape.com/article/367061-overview eMedicine Medical Library: Imaging in Adenocarcinoma of the Colon]
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* [http://emedicine.medscape.com/article/277496-overview eMedicine Medical Library: Colon Adenocarcinoma]
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* [http://www.merckmanuals.com/professional/gastrointestinal_disorders/tumors_of_the_gi_tract/colorectal_cancer.html Merck Manual: Colorectal Cancer]
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=== Journal Articles ===
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* 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.
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* Strum WB.  [http://www.nejm.org/doi/full/10.1056/NEJMra1513581 Colorectal Adenomas].  ''NEJM'' 2016 March 17 374:1065-1075.
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=== Images ===
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* [{{SERVER}}/library/index.php?/tags/66-colon/112-carcinoma PEIR Digital Library: Colon Carcinoma Images]
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* [http://library.med.utah.edu/WebPath/GIHTML/GIIDX.html#10 WebPath: Colon and Appendix]
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== Related IPLab Cases ==
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* [[IPLab:Lab 7:Metastatic Adenocarcinoma|Lab 7: Lung & Liver: Metastatic Adenocarcinoma]]
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* [[IPLab:Lab 7:Lip SCC|Lab 7: Lip: Squamous Cell Carcinoma]]
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* [[IPLab:Lab 7:Esophagus SCC|Lab 7: Esophagus: Squamous Cell Carcinoma]]
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* [[IPLab:Lab 7:IDC|Lab 7: Breast: Infiltrating Ductal Carcinoma]]
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* [[IPLab:Lab 7:Bronchogenic Carcinoma|Lab 7: Lung: Bronchogenic Carcinoma]]
  
 
{{IPLab 7}}
 
{{IPLab 7}}
  
 
[[Category: IPLab:Lab 7]]
 
[[Category: IPLab:Lab 7]]

Latest revision as of 01:16, 9 July 2020

Clinical Summary[edit]

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.

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.

Images[edit]

Virtual Microscopy[edit]

Study Questions[edit]


Additional Resources[edit]

Reference[edit]

Journal Articles[edit]

Images[edit]

Related IPLab Cases[edit]

Melena is the passage of digested blood in the feces.