[url]http://www.geocities.com/wah17/examin ation.doc[url]

Would like to get some help in trying to understand this report in layman term. Can someone help me please? (is as below or you can download it)

At the same time, please give me some opinions in terms of medication and also what are the available treatment for such diseases. Thanks.

Nature of Specimen: Right Colon
Gross Appearance:

Segment of intestine, composed of terminal ileum measuring 30cm in length and 5cm in broadest diameter, with 4cm diameter proximal surgical margin, appendix measuring 7.5 cm in length, 1.5 cm diameter and distended caecum with colon measuring 27cm in length and 10.5cm in broadest diameter. The distal surgical margin measures 3.8 cm in broadest diameter. The serosal surface of the terminal ileum is studded with whitish nodules, the largest about 3mm in diameter. Several nodules are seen in the attached mesentery, the largest being 2.5 x 2 x 1.5cm at the apex of the resection. A constricting tumour mass is present at the lower end of the caecum and proximal colon measuring 6cm in length involving the entire thickness and circumference of the colon measuring 6 cm in length involving the entire thickness and circumference of the colon wall constricting it. It is situated 6.5 cm from distal surgical margin and 14.5cm from the ileo-caecal junction. The appendix is thickened and congested. Several node varying in size from 1mm diameter to 1.5 x 1 x 1cm in broadest dimension are present in the pericolic tissue.

Representative Sections:

Block 1- Proximal end of tumour
Block 2- Full thickness of tumour
Block 3- Distal end of tumour
Block 4- Full thickness of tumour
Block 5- Nodules on the serosal surface of ileum
Block 6- 7- Appendix
Block 8- Mesenteric nodes
Blocks 9-10- Largest and smaller nodules at the apex of mesentery
Block 11-13- nodules in peri-colic fat adjacent to tumour
Block 14- proximal surgical margin
Block 15-16- distal surgical margin
Miroscopic Appearance:

Sections show transmural infiltraton of the colon by poorly differentiated malignant tumour cells with marked variation of cell size. They have pleomorphic vesicular irregularly shaped nuclei, prominent nucleoli and frequent mitoses. There are large areas of mucosal ulceration with replacement by fibriniod necrotic slough and areas of tumour necrosis. Tumour is also seen with the submucosa, muscularis propria and serosa of the ileum. There is transmural involvement in the appendix, and extensive lymphovascular invasion in sections of the ileum and colon. Metastatic tumour is present in all the pericolic nodes samples and twelve out of nineteen ileo-colic nodes including the largest at the apex of the mesentry. Both proximal and distal surgical margins are clear.

Interpretation:
Right Colon: Ulcerated poorly differentiated Adenocarcinoma of the colon involving the entire thickness of the wall, extending to pericolic tissues, with vascular, pericolic and ileo-colic node metastases Duke’s Stage C.