Anatomical Pathology Interesting Case Conference

Date of Presentation:12/20/2021

Attending pathologist: Ashwini K Esnakula, MD

Presented by: Bindu Challa, MD

Prepared by: Bindu Challa, MD

Organ:Small Bowel

HISTORY:

A 51 year old male presents with bleeding per rectum since few days. He reports history of small bowel tumor resection at age 10. He was placed on IV proton pump inhibitors. Colonoscopy was performed and showed multiple pedunculated, sessile and semi-pedunculated polyps ranging from 2 mm to 12 mm in size. He was followed up with total colectomy and specimen was sent for pathology examination.

GROSS:

Small bowel endoscope image
Small bowel endoscope image
Small bowel endoscope image
Gross image of small bowel
Gross image of small bowel
Microscopic image possibly detecting cancerous areas in human tissue
Microscopic image possibly detecting cancerous areas in human tissue
Microscopic image possibly detecting cancerous areas in human tissue
Microscopic image possibly detecting cancerous areas in human tissue
Microscopic image possibly detecting cancerous areas in human tissue
Microscopic image possibly detecting cancerous areas in human tissue
Microscopic image possibly detecting cancerous areas in human tissue
Microscopic image possibly detecting cancerous areas in human tissue

What is the most likely diagnosis?

  1. Peutz-Jeghers polyposis with high grade dysplasia
  2. Peutz-Jeghers polyposis with invasive adenocarcinoma
  3. Mucosal prolapse with high grade dysplasia
  4. Mucosal prolapse and invasive adenocarcinoma
  5. Colitis cystica profunda with invasive adenocarcinoma
Peutz-Jeghers polyposis with invasive adenocarcinoma

CASE SUMMARY