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[Solved] Case Study: Adenocarcinoma of the colon

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[Solved] Case Study: Adenocarcinoma of the colon

Case Study: Adenocarcinoma of the colon

      

A 65 year old woman was referred by her GP after reporting seeing blood in her stools and having had a short history of needing to go to the toilet more often than usual. She reported that her stools had been looser for some time. She complained of feeling bloated after eating meals and she had lost her appetite. The GP recorded that she had lost weight since her last visit. She was otherwise in good health.

This patient was investigated for ?bowel cancer. Clinical and imaging investigations suggested a moderately large mass in her colon. A small lesion was also found in her liver and this was subsequently found to map to a hot spot in a PET scan.

The mass, along with its draining lymph nodes was resected. A core biopsy was taken from the liver lesion and investigated using chromogenic immunohistochemistry. Anti-keratin 20 and anti-keratin 7 were included in the investigative panel.

The cellular pathology report suggested the presence of a moderately differentiated adenocarcinoma arising within the mucosa and associated with an acute inflammatory infiltrate. There was evidence of perforation through the mesorectal surface. Samples from the pelvic sidewall also showed show tumour deposits. The liver lesion was confirmed to be a metastatic tumour arising from the distal bowel.

Image 1 - sample of uninvolved tissue (HE)

 

 

 

 

 

 

 

 

 

Image 2 - tumour sample (HE)

 

 

 

 

 

 

Image 3 - mesorectal bowel sample  (HE)

 

 

 

 

 

 

Image 4 - sample of the pelvic wall (HE)

 

 

 

 

 

 

 

Image 5 - epicolic lymph node (HE)

 

 

 

 

 

 

 

 

 

 

Image 6 - liver core biopsies (HE)

 

 

 

 

 

 

Image 7 - liver core biopsies (anti-K20 IHC)

 

 

 

 

 

 

Image 8 - liver core biopsies (anti-K7 IHC) 

 

 

 

 

 

 

 

 

  1. Study the Whole slide images (WSI) of the HE-stained sections in Images 1-5. Describe the histopathology of the primary tumour using appropriate technical terminology and accurately labelled images and diagrams as evidence. (35%, 800 words)
  2. With reference to the three differently stained WSIs of the liver core biopsy, explain how immunohistochemistry can be used to support the suggestion that the aberrant tissue morphology seen in the liver arises from the glandular epithelium of the colon. This part of the report will be a short presentation online presentation (created with Explain Everything, for example). The presentation will consist of a narrated discussion supported by relevant images taken from WSB. You should use labels or a pointer to make clear the features you are discussing. (30%, 500 words)
  3. With reference to all of the evidence available to you, discuss the staging of the patient’s tumour and its significance for her prognosis. You may wish to consider any additional investigations that could be requested. (35%, 800 words)
  4. Bibliography and references. The report must be referenced correctly and consistently using Westminster Harvard

 

 

 

 

 

 

 

 

 

 

 

 

 

 


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  • Title: [Solved] Case Study: Adenocarcinoma of the colon
  • Price: £ 108
  • Post Date: 2021-10-12T09:16:08+00:00
  • Category: Recent Student Quires
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[Solved] Case Study: Adenocarcinoma of the colon [Solved] Case Study: Adenocarcinoma of the colon
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