PAEC General Hospital, Islamabad Department of Histopathology Monday, February 22, 2021 Duplicate Report Patient Control# P-04/19-00534 Patient Name : NAZEERAN KHATOON Order# 02/21-02677__—Ref. B Ward :Surgical Ward Room #:HalliF Bed #:12 Receipt# 160272021 122823PM Specimen : Intestine Clinical Notes: Site: Intestinal mass; Resection NOS No clinical details have been provided. Gross Examination ‘Surgical No. $-21-143 ‘Specimen received in formalin labelled with patient's name, PCN and marked for site as Intestinal mass. Specimen received consists of an unoriented segment of large bowel measuring 16cm in length and 4,Scm in average diameter. Attached mesentery measures 21x7xScm. The external serosal surface shows a defect/perforation measuring 3x2cm. This site of perforation is grossly located at a distance of 1cm from ane resection margin, 11cm from other resection margin and 17cm from mesenteric resection margin. On opening the bowel, a polypoidal, fungating and Ulcerating tumour is identified at the site of perforation. The tumour measures 4x4x1.4cm, This tumour invades the ‘muscularis propria and reaches and perforates the serosal surface. The tumour Is located at a distance of 1em from one resection margin, 11cm from other resection margin and 17cm from mesenteric resection margin. Cut surface of the tumour is grayish white and friable. The adjacent bowel wall shows hyperemic, congested mucosa. No satellite tumour {deposit identified. Multiple Iymph nodes ranging in size form 0.2cm to 2cm aré identified in the pericoic tissue. No satellite tumour deposit identified. Representative sections are submitted In following cassettes as follows: ‘One resection margin Bi Other resection margin Mesenteric resection margin Random sections from perforated tumour: Full thickness sections of tumor with serosa ‘Section of the tumor with adjacent mucosa 3: Random section from normal bowel i: 02 lymph nodes 02 lymph nodes M: 10 lymph nodes 05 lymph nodes (02 lymph nodes 03 lymph nodes De Fa Microscopic Examination: + Procedure: Colectomy NOS + Tumor Site: Colon, not otherwise specified = Tumor size: Greatest dimension: 4em ‘Additional dimensions: 4x1.4cm = Macroscopic tumor perforation: Present + Histologic type: Mucinous adenocarcinoma + Histologic Grade: G2: Moderately differentiated = Tumor Extension: Tumor invades the visceral peritoneum (Including tumour continuous with serosal surface through area oF inflammation) + Margins: ‘Tumour involves the mesenteric margin, Iymph node involved Proximal Margin: Uninvolved by invasive carcinoma Distal Margin: Uninvolved by invasive carcinoma Mesenteric Margin: Involved by invasive carcinoma ~ Treatment Effect: No known presurgical therapy = Lymphovascular Invasion: Present + Perineural Invasion: Not identiied = Tumor Deposits: Not identified at Hospital StI AU? gg AP esteheT p.04i9-00536 2 Page Ta -U Us LT Pace onPAEC General Hospital, Islamabad Department of Histopathology Monday, February 22, 2021 Duplicate Report + Regional Lymph Nodes: Number of lymph nodes involved: 11 Total iymph nodes examined: 25 + Pathologic Stage Classification: Primary Tumor (pT): pT4a: Tumor invades through the visceral peritoneum (including gross perforation of the bowel thorugh tumour and continuous invasion of tumour through areas of inflammation to the surface of the visceral Peritoneurn) Regional Lymph Nodes (pN): pN2b: Seven or more regional lymph nodes are positive Distant Metastasis (pM): pMx + Additional pathologic findings: ‘adenoma Diagnosis COLON; COLECTOMY NOS: ~ MUCINOUS ADENOCARCINOMA, MODERATELY DIFFERENTIATED, 4.0CM “TUMOR INVADES MUSCULARIS PROPRIA AND PERFORATES THE SEROSAL SURFACE (4) ~ TUMOUR INVOLVES MYSENTERIC RESECTION MARGIN (LYMPH NODE POSITIVE IN MESENTERIC MARGIN) PROXIMAL AND DISTAL RESECTION MARGINS, FREE OF TUMOR, ~ LYMPHOVASCULAR INVASION SEEN = 11/25 LYMPH NODES, POSITIVE FOR METASTATIC CARCINOMA WITH EXTRA NODAL EXTENSION pT4a, pN2b, pMX Comments: Please also see surgical reports no. S-21-144 and 145 of the same patient. Dr. Amna Babar Dr. Sundas Saba Dr, Faiza Kazi Consultant Histopathologist ‘SMO Histopathology Consultant Histopathologist Reporting Date : Monday, February 22, 2021 User Name : Tainoor MLE og ALP erie T -0419.0084 2 -UUELe1ZLT PAEC General HospitalPAEC General Hospital, Islamabad Department of Histopathology Monday, February 22, 2021 Duplicate Report Patient Control P-04/19-00534 Patient Name : NAZEERAN KHATOON ‘Age : 60 Years) Order# 0221-02679 Ref. By : Sex: Male Receipt# we Ward :Surgical Ward Room #:HalliF Bed #:12 Sample Date :0sW7021 122951 PM Specimen : OMENTUM Small Biopsy Clinical Notes: site: Omentum tissue No clinical details have been provided Gross Examination ‘Surgical No. S-21-144 Specimen received in formalin labelled with patient's name, PCN and marked for site as omentum, Specimen received consists of two fibrofatty tissue fragments. Smaller fragment measures 2.5x2x2.7cm. Serial sectioning shows fatty cut surface, No Solid area seen, Larger fragment measures 4.5x4x2cm. Serial sectioning reveals a nodule Measuring 2.5x1-5x1em. This nodule has white mucoid cut surface. Representative sections are submitted as follows; ‘A: Smaller fragment entirely submitted B-D: Random sections from larger fragment with nodule Microscopic Examination: “The sections examined reveal fibroadipose tissue Inftrated by a tumour. This tumour is exhibiting glandular configuration lined by tall columnar cells with apical mucin. The individuat cells are large with high N/C ratio. Abundant mucin pools noted. Diagnosis ‘OMENTUM; BIOPSY:- = OMENTUM, INVOLVED BY METASTATIC CARCINOMA ‘Comments: Please also see surgical reports no. $-21-143 and 145 of the same patient, Dr. Amna Babar Dr, Sundas Saba Dr, Faiza Kazi Consultant Histopathologist SMO Histopathology Consultant Histopathologist Reporting Date : Monday, February 22, 2021, User Name : Teimoor Hospital St AM? ge AP 7 p.04t9-00534 2 ITTPAEC General Hospital, Islamabad Department of Histopathology Monday, February 22, 2021 Duplicate Report < > [Patient Control# P-04/19-00534 Patient Name : NAZEERAN KHATOON ‘Age: 60 Year(s) | 02721-02681 Ref. By Sex : Male sees Ward :Surgical Ward Room #:HalliF Bed #:12 02/2021 1233029 PM | Specimen : BIOPSY ‘Small Biopsy Site: Wall biopsy No clinical details have been provided. Gross Examination ‘Surgical No, S-21-145 ‘Specimen received in formalin labelled with patient's name, PCN and marked for site as wall biopsy. ‘Specimen received consists of unoriented fragmented fibrofatty tissue. The smaller fragment measures 2x1.5xicm. Serial ‘sectioning shows cystic cut surface with necrotic focus. Larger tissue measures 6x3x2cm. Serial sectioning shows fibrofatty cut surface. Representative sections are submitted as follows; ’A-B: Random sections from smaller fragment C-D: Random sections from larger fragment Microscopic Examination: ‘The sections examined reveal fibroadipose and fibromuscular tissue infiltrated by a tumour. This tumour is exhibiting glandular configuration lined by tall columnar cells with apical mucin, The individual cells are large with high N/C ratio. ‘Surrounding tissue shows pools of mucin. Diagnosis WALL BIOPS\ - FIBROADIPOSE AND FIBROMUSCULAR TISSUE/ WALL BIOPSY, INVOLVED BY METASTATIC CARCINOMA ‘Comments: Please also see surgical reports no. $-21-143 and 144 of the same patient. Dr. Amna Babar Dr. Sundas Saba Dr. Faiza Kazi Consultant Histopathologist ‘SMO Histopathology Consultant Histopathologist Reporting Date : Monday, February 22, 2021 ‘User Nam teat LIE gg AL etiheeT 0419-0054 Page TAT “LUA IZLT PAEC General Ho: