PMC3625879_01
Aditi Jain
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F1
Toshiba single-slice spiral CT scanner revealed ileocolic intussusception with the lead point being an intraluminal heterogeneously enhancing mass in the cecum with associated irregular wall thickening [Figures 1 and 2] resulting in small bowel obstruction. The mass measured 3 x 3.5 cm in size. Few of the distal ileal loops showed thickened walls with mesenteric haziness in the right iliac fossa and minimal ascites, multiple enlarged mesenteric nodes ranging from 10 to 14 mm were seen in the right lumbar and the right iliac fossa with few of them showing central necrosis [Figure 1].
Contrast enhanced computed tomography of abdomen and pelvis (axial section) shows A. Enhancing Intraluminal caecal mass with caecal wall thickening. B. Adjacent necrotic mesentric nodes and C. Dilated small bowel loops with few of them having thickened walls.
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F2
Toshiba single-slice spiral CT scanner revealed ileocolic intussusception with the lead point being an intraluminal heterogeneously enhancing mass in the cecum with associated irregular wall thickening [Figures 1 and 2] resulting in small bowel obstruction. The mass measured 3 x 3.5 cm in size.
Contrast enhanced computed tomography of abdomen and pelvis (axial section) reveals thickened ileum loop extending into the cecum (arrow).
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F3
Histopathology examination of the cecal mass revealed sheets, cords, and islands of monomorphic large cells with large round nucleus and abundant cytoplasm [Figure 3a and b] infiltrating the layers of cecum up to the peritoneum.
Hematoxylin and eosin stained sample (a) at x10 and (b) at x40 demonstrate large monomorphic tumor cells having large round cell nucleus and abundant eosinophilic cytoplasm (seen arranged in cords and nests in Figure 3a).
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F4
Nests and islands of tumor with vague glandular structures amounting to more than 30% of the tumor [Figure 4a and b] were seen originating from cecal mucosa and infiltrating the wall amidst pools of extracellular mucin.
Hematoxylin and eosin stained tissue (a) at x10 and (b) at x40 show glandular formation (arrow) amounting to >30% of the tumor.
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F5
Focal aggregate of lymphocytes was also seen [Figure 5].