DIAGNOSIS:
A) Large intestine, (ascending colon, 57cm from anal verge), endoscopic submucosal dissection:
Adenocarcinoma, Moderately Differentiated,1.9cm x 1.5cm x 0.15cm,
with 1) invasion to submucosa (depth of submucosal invasion: 1.5mm from muscularis mucosae)
2) lymphovascular invasion: not identified
3) large vessel (venous) invasion: not identified
4) perineural invasion: not identified
5) tumor budding (one x200 field): low (0-4)
6) clear deep and lateral resection margins (safety margin: < 0.1mm from deep resection margin)
B) Large intestine, (ascending colon, 57cm from anal verge), endoscopic polypectomy:
- Tubular adenoma with clear resection margin
C) Large intestine, (ascending colon, 57cm from anal verge), endoscopic biopsy:
- Focal active colitis with perivascular fibrin extravasation, suggestive of ischemic colitis.
GROSS:
A.
1. Specimen status: Formalin fixed
2. Procedure: Endoscopic submucosal dissection
3. Specimen size : 3 x 2.3 x 0.2 cm
4. Lesion:
A well-demarcated, slightly elevated, firm lesion
(1.9 x 1.5 x 0.15cm)
- 0.2 cm apart from the nearest peripheral resection margin
- Cross section : extension to submucosa
5. Photo (x1)
6. Ink code: black - deep resection margin,
red, green & yellow - peripheral resection margins
7. Slide keys: 4 cassettes (entire),
B. Two (0.4cm and 0.3 cm) pieces, 1 cassette, entirely.
C. Two (0.3cm and 0.2 cm) pieces, 1 cassette, entirely.
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대략적으로 상행결장 중분화 선암이고, 점막하 종양에 1.5mm 침윤인 것까진 알겠는데...
tumor budding 이 정확히 무엇을 의미하는지 one x200field 가 무슨 의미이고 low 면 좋은 거 같은데 맞는지 모르겠습니다.
resection margin도 무얼 의미하는지 잘 모르겠고...
전반적인 해석과 설명해주시면 매우 감사드리겠습니다.