Presentation
Constipation from 8 months ago.
Patient Data
Circumferential mid to high rectal intermediate signal intensity lesion with 54 mm length, 76 mm far away from the anal margin is seen that shows heterogeneous enhancement after contrast injection. Extension of the mass / beyond the muscular propria layer into the mesorectal fat also is seen.
Two abnormal signal enhancing lymph nodes are seen in the mesorectum (SAD : 3 mm) and next to the internal iliac chain (SAD: 7mm) on the left side respectively.
Case Discussion
T3 tumors are those that extend beyond the wall of the rectum (i.e. beyond the muscularis propria) and into the perirectal fat without reaching the mesorectal fascia or adjacent organs.
The patient underwent colonoscopy and biopsy.
Microscopic:
Tiny fragments of the large intestinal mucosa are seen in sections, harboring a malignant lesion, composed of atypical and irregular fused and branching glands, focal cribriform and papillary structures, lined by a single or pseudostratified layer of epithelial cells with moderate atypical nuclear features, and almost frequent mitotic figures. foci of desmoplasia and considerable infiltration of inflammatory cells also are observed.
Final diagnosis: Adenocarcinoma, well to moderately differentiated.
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