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Presented by Ralph Hruban, M.D. and prepared by Marc Halushka M.D., Ph.D.
Case 2: This elderly patient presented with diarrhea.
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Question 1 of 1
1. Question
Week 161: Case 2
This elderly patient presented with diarrhea.images/Halushka/conf111003/case2image1.jpg
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images/Halushka/conf111003/case2image5.jpgCorrect
Answer: Carcinoid tumor with secondary lymphatic obstruction
Histology: Two processes are seen. The first is a widely disseminated well-differentiated neoplasm with lymphatic invasion. The second is dilation of the lymphatics in the bowel.
Discussion: This is a dramatic case of a carcinoid tumor extensively involving the lymphatics of the bowel with secondary lymphostasis. Microscopically, carcinoid tumors are characterized by nests of well-differentiated cells with uniform round nuclei. The nuclei have a “salt and pepper” chromatin pattern. Small bowel carcinoids less than 2 cm without angioinvasion are generally benign, but, as demonstrated in this case, those > 2 cm and those with angioinvasion can follow a malignant course.
Incorrect
Answer: Carcinoid tumor with secondary lymphatic obstruction
Histology: Two processes are seen. The first is a widely disseminated well-differentiated neoplasm with lymphatic invasion. The second is dilation of the lymphatics in the bowel.
Discussion: This is a dramatic case of a carcinoid tumor extensively involving the lymphatics of the bowel with secondary lymphostasis. Microscopically, carcinoid tumors are characterized by nests of well-differentiated cells with uniform round nuclei. The nuclei have a “salt and pepper” chromatin pattern. Small bowel carcinoids less than 2 cm without angioinvasion are generally benign, but, as demonstrated in this case, those > 2 cm and those with angioinvasion can follow a malignant course.
