PMC9651067_01
Preoperative computed tomography: (A) coronal CT scan images at presentation showing soft tissue mass in the lower pole of the caecum associated with multiple metastatic regional lymph nodes (B) Axial CT scan images at presentation showing soft tissue mass in the lower pole of the caecum (arrow) (C) Axial CT scan images at presentation showing multiple enlarged lymph nodes located along the course of the ileocolic vessels measures about 4.7*6.4 cm in axial dimension.
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Computed tomography scans presented soft tissue mass lesion in the lower pole of the cecum associated with multiple enlarged regional lymph nodes only, without any liver or lung lesions (Figure 1).
(A) 100X H&E stained section of colonic mass, (B) 200X H& E stained section of colonic mass, (C) 400X H&E stained section of colonic mass, (D) 200X H&E stained section of colonic mass.
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Also, biopsy showed clonal plasmacytosis (Immunoreactive for CD138, CD56 and negative for CD3 and CD20 and lambda light chain restricted); a picture consistent with plasmacytoma (Figures 2 and 3). The tumor infiltrates the muscular wall of the intestine and the pericolic fat (Figure 2). The tumor cells were immunoreactive for CD138+, CD56+ and showed lambda light chain restriction (Figures 2 and 3).
(A) CD138 immunostain (IHC400X) (B) CD56 immunostain (IHC400X) (C) Lambda light chain immunostain (IHC 400X).
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Also, biopsy showed clonal plasmacytosis (Immunoreactive for CD138, CD56 and negative for CD3 and CD20 and lambda light chain restricted); a picture consistent with plasmacytoma (Figures 2 and 3). The tumor cells were immunoreactive for CD138+, CD56+ and showed lambda light chain restriction (Figures 2 and 3).
Preoperative PET scan showed: Hypermetabolic malignant right colonic (caecal) mass, which is compatible with known primary tumor and multiple hypermetabolic regional mesenteric lymph nodes metastases.
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PET scan done and showed hypermetabolic malignant cecal mass with hypermetabolic regional mesentric lymph nodes (figure 4).