PMC8606888_01
Abdominal computed tomography of patient. (A1-D1) Contrast-enhanced CT on February 2, 2020 showed that the small intestine in the right middle abdomen was occupied by tumor with multiple enlarged lymph nodes. (A2-D2) Abdominal CT on October 6, 2020 showed that the obstruction of intestinal lumen was relieved after operation 2020.
fmed-08-764233-g0001.jpg
PMC8606888_01_fmed-08-764233-g0001.jpg
F1
The superior and inferior mesenteric vein trunks and their major tributaries were nearly occluded at the level adjacent to the tumor [Figures 1(A1-D1)]. Now he was considered to be in complete remission according to the Fluorodeoxyglucose-positron emission tomography (FDG-PET) image and other assessment [Figures 1(A2-D2), 4].
Surgical findings. Enlarged lymph nodes were identified in the root of the mesentery in addition to the mass tumor in the small intestine.
fmed-08-764233-g0002.jpg
PMC8606888_01_fmed-08-764233-g0002.jpg
F2
Meanwhile, multiple swollen lymph nodes could be found in the mesentery root and around the abdominal aorta, some of which has fused into a mass (Figure 2). Now he was considered to be in complete remission according to the Fluorodeoxyglucose-positron emission tomography (FDG-PET) image and other assessment [Figures 1(A2-D2), 4].
Histopathological findings and immunohistochemistry. (A) Histological findings showed tumor cells with cytoplasm rich in eosinophilic granules and clear nucleoli that showed dense proliferation. (B) PD-1. (C) PD-L1. (D) MLH1. (E) MSH2. (F) MSH6. (G) PMS2. (H) Ki67. The first image in each group was viewed from a macro perspective. The scale bars of second picture in each group was 300 mum.
fmed-08-764233-g0003.jpg
PMC8606888_01_fmed-08-764233-g0003.jpg
F3
Immunohistochemical results showed that cytokeratin CK7(-), cytokeratin CK20(+), Ki-67(70%), p53(+), MLH1(+), PMS2(+), MSH2(:/+), MSH6(-) (Figure 3).
FDG-PET scan shows no metastatic lesions and lymph node.
fmed-08-764233-g0004.jpg
PMC8606888_01_fmed-08-764233-g0004.jpg
F4
Now he was considered to be in complete remission according to the Fluorodeoxyglucose-positron emission tomography (FDG-PET) image and other assessment [Figures 1(A2-D2), 4].