DZI20-200-Case-4
4th slide: ""jejunal margin of hepatojejunostomy"" - tubular ST, EF-->FX2 (4th slide).
5th slide: ""new proximal left duct margin"" - tubular ST, EF-->FX3 (5th slide)"FX1A(Right hepatic duct margin): high-grade dysplasia with concern for cancerization of duct. FX#1B(common hepatic duct margin): Adenocarcinoma. FX#2(jejunal margin of hepaticojejunostomy): c/w reactive atypia FX#3(new proximal duct margin): Positive for adenocarcinoma" "Permanent: FX1 (left and common hepatic duct margin): Invasive adenocarcinoma FX1A(Right hepatic duct margin): High-grade dysplasia FX1B(common hepatic duct margin): invasive adenocarcinom FX2(jejunal margin of hepaticojejunostomy): Small intestine with marked reactive atypia and acute and chronic inflammation. TINEM.
FX3(New proximal left duct margin): invasvie adenocarcinoma, best seen on FX slides."
Annotations and notes
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Clinical history
"Cholangiocarcinoma. (Slides 1-3): ""Right, left and common hepatic duct"" - oriented Y-shaped tubular portion of ST. Left hepatic duct shaved --> FX1 (1st slide), Right hepatic duct shaved --> FX1A (2nd slide), common hepatic duct shaved --> FX1B (3rd slide). Specimen opened to reveal a thickened fibrotic wall (up to 0.6 cm). 4th slide: ""jejunal margin of hepatojejunostomy"" - tubular ST, EF-->FX2 (4th slide). 5th slide: ""new proximal left duct margin"" - tubular ST, EF-->FX3 (5th slide)"
Diagnosis
"FX1(left hepatic duct margin): Positive for malignancy. FX1A(Right hepatic duct margin): high-grade dysplasia with concern for cancerization of duct. FX#1B(common hepatic duct margin): Adenocarcinoma. FX#2(jejunal margin of hepaticojejunostomy): c/w reactive atypia FX#3(new proximal duct margin): Positive for adenocarcinoma" "Permanent: FX1 (left and common hepatic duct margin): Invasive adenocarcinoma FX1A(Right hepatic duct margin): High-grade dysplasia FX1B(common hepatic duct margin): invasive adenocarcinom FX2(jejunal margin of hepaticojejunostomy): Small intestine with marked reactive atypia and acute and chronic inflammation. TINEM. FX3(New proximal left duct margin): invasvie adenocarcinoma, best seen on FX slides."
Slides
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