PMC7145160_01
Colonoscopy showing focal scarring and puckering of mucosa in the descending and sigmoid colon mimicking the appearance of healed ulcers.
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F1
Further evaluation included a diagnostic upper gastrointestinal endoscopy which was normal and a colonoscopy which showed multiple discrete lesions, separated by normal mucosa, in the descending and sigmoid colon with focal scarring and puckering of the mucosa, suggestive of tumor infiltration from the serosa (Figure 1).
Colonic biopsy. Neoplastic glands (A) showing diffuse strong positive staining for CK7 and (B) are predominantly negative with only a few tumor cells showing positive staining for CK20 (40x).
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F2
Immunohistochemistry performed on both the biopsies showed diffuse positive staining of tumor cells for cytokeratin 7 (CK7) and only few cells for cytokeratin 20 (CK20), thereby confirming primary pancreatic adenocarcinoma with colonic metastases (Figures 2 and 3).
Fine-needle aspiration biopsy of the pancreas. Neoplastic glands showing (A) diffuse strong positive staining for CK7 and (B) focal positive staining in a few tumor cells for CK20 (400x).
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F3
Immunohistochemistry performed on both the biopsies showed diffuse positive staining of tumor cells for cytokeratin 7 (CK7) and only few cells for cytokeratin 20 (CK20), thereby confirming primary pancreatic adenocarcinoma with colonic metastases (Figures 2 and 3).