2018년 5월 18일 금요일

Rectal carcinoid with lymph node metastasis

Rectal carcinoid로 의뢰된 환자입니다.

ESD가 시행되었고 병리소견에서 lymphatic invasion이 의심되었습니다.

 
Well differentiated neuroendocrine tumor (CARCINOID) (G1) 
1) size: 1.2x1.0 cm 
2) confined to mucosa and submucosa 
3) mitosis: 1/10 HPF 
4) lymphovascular invasion: suspicious (in one focus) 
5) perineural invasion: absent 
6) focal involvement of deep cauterized resection margin

수술을 시행하였고 아래의 결과였습니다.

Rectum, low anterior resection : Status post endoscopic submucosal dissection for well-differentiated neuroendocrine tumor 
. No residual tumor 
. Histologic type and grade: not identified (no residual tumor): 
1. Location: rectum 
2. Gross type: scar 
3. Size: cannot be determined (no residual tumor) 
4. Depth of invasion: cannot be determined (no residual tumor) 
5. Resection margin: free from carcinoma (no residual tumor) safety margin: proximal, 9.2 cm; distal, 0.5 cm; circumferential (radial), >10 mm 
6. Lymphovascular invasion: cannot be determined (no residual tumor) 
7. Perineural invasion: cannot be determined (no residual tumor) 
8. Regional lymph node metastasis: metastasis to 1 out of 12 regional lymph nodes (1/12: perirectal, 1/12)

직장 유암종 내시경 치료에서는 병리과 선생님이 매우 매우 매우 매우 중요합니다.


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