Quiz-summary
0 of 1 questions completed
Questions:
- 1
Information
Presented by Pedram Argani, M.D. and prepared by Natasha Rekhtman, M.D., Ph.D.
Case 4: 62 year old male who undergoes proctocolectomy s/p chemoradiation for colonic adenocarcinoma.
You have already completed the quiz before. Hence you can not start it again.
Quiz is loading...
You must sign in or sign up to start the quiz.
You have to finish following quiz, to start this quiz:
Results
Time has elapsed
Categories
- Not categorized 0%
- 1
- Answered
- Review
-
Question 1 of 1
1. Question
Week 252: Case 4
62 year old male who undergoes proctocolectomy s/p chemoradiation for colonic adenocarcinoma. The section is from the anal margin.images/1 9 05 case 4 1.jpg
images/1 9 05 case 4 2.jpg
images/1 9 05 case 4 3.jpg
images/1 9 05 case 4 4.jpg
images/1 9 05 case 4 5.jpgCorrect
Answer: Paget’s disease of the anus
Histology: There is a nearly-full thickness proliferation of atypical cells throughout the anal mucosa. Closer inspection reveals that these malignant cells occasionally demonstrate cytoplasmic vacuoles, lack melanin pigment, and do not form intercellular junctions with the adjacent squamous epithelial cells. Immunohistochemical studies revealed that these cells were immunoreactive for cytokeratin 7, cytokeratin 20, and CEA, but negative for GCDFP.
Discussion: Melanoma would label for HMB45 and S-100 protein. Squamous carcinoma in situ would typically not label for low molecular weight cytokeratins, but might label for high molecular weight cytokeratins like cytokeratin 903 (34ßE12).
Paget’s Disease is essentially an intraepithelial adenocarcinoma. In the anus, 50-75% of Paget’s Disease is associated with an underlying rectal or anal gland adenocarcinoma. These cases are usually immunoreactive for cytokeratin 7 and 20, but negative for GCDFP. The remaining anal Paget’s Disease cases are probably intraepithelial apocrine adenocarcinomas that are immunoreactive for cytokeratin 7 and GCDFP, but are negative for cytokeratin 20.
Reference(s):
– American Journal of Surgical Pathology 1997;21: 1178-1187.
– American Journal of surgical Pathology 1998;22: 170-179.Incorrect
Answer: Paget’s disease of the anus
Histology: There is a nearly-full thickness proliferation of atypical cells throughout the anal mucosa. Closer inspection reveals that these malignant cells occasionally demonstrate cytoplasmic vacuoles, lack melanin pigment, and do not form intercellular junctions with the adjacent squamous epithelial cells. Immunohistochemical studies revealed that these cells were immunoreactive for cytokeratin 7, cytokeratin 20, and CEA, but negative for GCDFP.
Discussion: Melanoma would label for HMB45 and S-100 protein. Squamous carcinoma in situ would typically not label for low molecular weight cytokeratins, but might label for high molecular weight cytokeratins like cytokeratin 903 (34ßE12).
Paget’s Disease is essentially an intraepithelial adenocarcinoma. In the anus, 50-75% of Paget’s Disease is associated with an underlying rectal or anal gland adenocarcinoma. These cases are usually immunoreactive for cytokeratin 7 and 20, but negative for GCDFP. The remaining anal Paget’s Disease cases are probably intraepithelial apocrine adenocarcinomas that are immunoreactive for cytokeratin 7 and GCDFP, but are negative for cytokeratin 20.
Reference(s):
– American Journal of Surgical Pathology 1997;21: 1178-1187.
– American Journal of surgical Pathology 1998;22: 170-179.
