Hi, I need a suggestion for regarding my father's pathology report. Can you give me an idea about the chemotherapy and survival rate.
RELEVANT CLINICAL HISTORY :
Cholelithiasis with choledocholithiasis. Post ERCP pancreatitis. Densely adhered splenic flexure. Left
paracolic gutter collection.
NATURE OF SPECIMEN
l. Splenic flexure of colon.
GROSS EXAMINATION :
L Received segment of large intestine closed ai both ends measuring 13cm long. Scm segment has
focally flattened mucosa with hemorrhage and normal to thinned out wall. Remaining part on external
surface is covered with blood. Wall of this part appears little thickened. Mucosa is normal. Pericolic fat
shows some yellow pecks.
A: Cut end near the thinned out part -2bits.
B: Other cut end -2bits.
C: Thinned out part -3bits.
D: Other part with little thickened wall -2bits (D1-D2).
E: Pericolic fat -1bit.
ll. Received unopen gall bladder measuring 11cm long. Serosa is congested. On cutting open two dark
greenish coloured stones seen measuring 1.5x1x0.5cm and 2.2x1.8x1cm. Mucosa is flat, gray brown
with focal hemorrhage. One area of mucosa shows papillary surface measuring 1.3x1cm. Wall thickness
measures 2mm to 5mm.Cystic lymphnode not identified.
F: Gall bladder -4bits (F1-F4).
MICROSCOPIC EXAMINATION :
l. Splenic flexure colon:
A: Sections from one cut end show moderate lymphoplasmacytic infiltrate and lymphoid follicle in
B:Sections from other cut end show mild lymphoplasmacytic infiltrate in lamina propria. Scattered
lymphoplasmacytic cells in submucosa and muscularis propria. Serosa shows fibrinous exudate,
inflammatory granulation tissue with infiltrate of neutrophils and numerous foamy histiocytes and
C: Sections from thinned out part show mild lymphoplasmacytic infiltrate in lamina propr,ia. Wall shows
edema, hemorrhage and vascular congestion.
D: Sections from other part of intestine show mild lymphoplasmacytic infiltrate in lamina propria with
sprinkling of cells in submucosa and muscularis propria. Subserosa show hemorrhage, fibroblastic
proliferation and inflammatory granulation tissue with infiltrate of numerous foamy histiocytes admixed
with lymphocytes, plasma cells and neutrophils.
-Sections from pericolic fat (D2, E) show fat necrosis, inflammatory granulation tissue and fibroblastic
ll. Gall bladder.
Sections from papillary arca show mucosal papillary projections and glandular proliferation. Lining is tall
columnar with intestinal and pyloric metaplasia and pseudostratification. Nuclei are large round to
elongated with granular chromatin, prominent nucleolus and exhibit anisonucleosis. Occasional mitotic
figure is seen.Dysplastic glands with irregular shape and intraluminal papillary projection are seen
infiltrating through fibromuscular layer into perimuscular connective tissue. Marked inflammatory infiltrate
comprised of neutrophils, lymphocytes, plasma cells, smooth muscle hypertrophy and fibrosis is also
-Sections from other part of wall show ulceration, papillary hyperplasia, metaplasia, dysplasia fibrosis,
marked inflammatory infiltrate and focally an invasive adenocarcinoma infiltrating into perimuscular
Serosa, cut margin of bare area and proximal cut margin are free of tumour involvement.
-Perineural invasion -Focally seen.
-Lymphovascular invasion -not seen.
l. Splenic flexure, colon:
* Subserosal fibroblastic proliferation and inflammatory granulation tissue.
-Pericolic fat -Fat necrosis, inflammatory granulation tissue and fibroblastic proliferation.
ll. Gall bladder:
-Well differentiated papillary adenocarcinoma, infiltrating into perimuscular connective tissue (Pathologic
TNM stage -PT2pNxMx)
-Serosa, bare area and proximal cut margin are free of tumour involvement.
I am very tensed about my father's health condition. Your suggestion is most valuable for me.
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