PMC9935056_01
Abdominal CT scan with contrast. (a): Axial section. (b): Coronal section. The arrow indicates the point of tumorous intestinal stenosis, causing retrograde dilation of the proximal small intestinal loops.
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figure1
There was apparent jejunum infiltration, causing dilation of the proximal small intestinal loops and intestinal obstruction (Figure 1).
Macroscopy. (a): Intraoperative in vivo finding, showing the largest area with obstruction due to stenosis. (b): External surface of the surgical specimen opened and laid flat post-resection. (c): Intraluminal surface of the surgical specimen opened and laid flat, showing involvement of the entire intestinal wall and intestinal mucosa.
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The second lesion measured 2 x 2 cm and was 50 cm cephalic to the first and was partially attached to the intestinal lumen (Figure 2).
(a): Diffusely infiltrative tumour within the jejunal mucosa (H-E 100x). (b): Tumour cells are small, blue and uniformly round in shape. They have a high nuclear-to-cytoplasmic ratio, round-to-oval hyperchromatic nuclei with finely dispersed chromatin (salt and pepper), indistinct nucleoli, mitosis and conspicuous apoptotic bodies (H-E 400x).
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The final pathology report concluded that both lesions were consistent with metastatic MCC (Figure 3), with involvement of the serous membrane of the jejunal wall but no lymphovascular or perineural invasion.