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<p><strong><em><u>Specimen Received:</u></em></strong></p><p>A: Left hemicolectomy</p><p>B: Splenectomy</p><p>C: Segment of small intestine</p><p><strong>Diagnosis</strong>:</p><p>Adenocarcinoma</p><p>Histologic type: Gland-forming (moderately differentiated)</p><p>Histologic grade: Grade 2</p><p>Tumor extension: Tumor invades through the muscularis propria into the subserosa and extends to the visceral peritoneum (serosa) with gross perforation</p><p>Lymph nodes: Negative for malignancy (0/17)</p><p><strong>Spleen</strong>: Negative for malignancy</p><p><strong>Small intestinal segment: Ne</strong>gative for malignancy</p><p>Lymphovascular invasion: Not identified</p><p>Perineural invasion: Not identified</p><p>Tumor budding: Low score</p><p><strong>Surgical margins:</strong></p><p>Proximal margin: Negative (14 cm from tumor)</p><p>Distal margin: Negative (7 cm from tumor)</p><p>Radial (circumferential) margin: Negative</p><p><strong>Pathologic Staging (AJCC):</strong></p><p>Primary tumor: pT4b (tumor directly perforates the visceral peritoneum)</p><p>Regional lymph nodes: pN0 (0/17)</p><p>Distant metastasis: pM0 (no metastasis in submitted spleen or small intestine)</p><p>Anatomic stage group: Stage IIC</p>
<p>Lt. sided colon mass.</p>
<p class="ql-align-justify">Received is a left hemicolectomy specimen measuring 30 cm long with attached mesenteric fat. Opening revealed a solid, firm, creamy greyish mass measuring 9 x 5.5 x 4.8 cm, with perforation in an area of 4 cm. The tumor was located 14 cm away from the proximal margin and 7 cm away from distal margin. Seventeen lymph nodes were dissected, with the largest measuring 0.7 cm. Also received is a splenectomy measuring 12 x 7 x 4.2 cm with unremarkable cut section. Additionally, there is a separate segment of small intestine measuring 3 x 2 cm, unremarkable grossly.</p>
<p><strong><em><u>Colon, left hemicolectomy: </u></em></strong></p><ul><li class="ql-align-justify"><strong>Adenocarcinoma (G2), stage pT4b pN0 (0/17) pM0, with serosal perforation.</strong></li><li class="ql-align-justify"><strong> Margins are negative.</strong></li><li class="ql-align-justify"><strong>Spleen and small intestine free of malignancy.</strong></li></ul>
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