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Pelvic mass.
07/20/2010
60-year-old female with weight loss, multiple pelvic masses, ascites, and possible omental caking. Hx. of colon cancer. Negative for recent colonoscopy.

Procedure: CT guided ovarian(pelvic) mass needle biopsy.

Micro: Sections show tumor composed of clusters of cell nests which are composed of basically two cell types. One cell type has abundant eosinophilic cytoplasm and rounded to angular nuclei of moderate size with coarse chromatin and, often, small nucleoli. The other cell type is a mucous-producing signet ring cell. Rare mitotic figures are noted. There are foci of intraluminal tumor necrosis. H & E stain

Special stain: Mucicarmine stain is positive for both intracellular mucin and areas of extracellular pools of mucin.

IHC:
Pankeratin (AE-1/AE-3 Positive, diffuse
CK-7 Negative
CK-20 Positive, diffuse
Chromogranin A Positive, patchy and scattered
Synaptophysin Negative
NSE Positive, scattered
Inhibin Negative
Ki-67 Positive (about 10 - 15% of tumor cells, low to moderate nuclear proliferation rate)
Thymidylate Synthase (TS) Positive (both cytoplasmic & Nuclear: associated with response to 5-FU in colorectal cancer)

Molecular study:
No KRAS mutations were detected by PCR.

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    Image12(CK-20)
    Image13(Chromogr...
    Image20 (TS)
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    Comments

    28/07/10
    Metastatic adenocarcinoma
    ShabnamBangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka, Bangladesh
    0
    Metastatic adenocarcinoma possibly from colon
    26/07/10
    metastatic
    pseudobanuAnkara University Faculty of Medicine
    0
    it must be musinous colon ca or appendiceal ca with CK7/20 profile