College of American Pathologists

2011 — February Case of the Month

Posted March 04, 2011


CAP Foundation February 2011 Online Case of the Month

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A 65-year-old man with a history of colon cancer that was resected 10 years ago presented with small bowel obstruction. During emergency laparotomy, two stenotic, napkin ring-like lesions were seen within a 50.0 cm loop of small bowel that was subsequently resected. There was no intraoperative evidence of tumor elsewhere. Immunostains show the tumor cells to be positive for cytokeratin and CDX-2, and negative for chromogranin and synaptophysin.

The master list with the correct answer

  • Adenocarcinoma
  • Adenocarcinoma of small bowel, arising
     in celiac disease

  • Gastrointestinal stromal tumor (GIST)
  • Metastatic medullary carcinoma
  • Moderately differentiated neuroendocrine
     tumor (atypical carcinoid)

  • Neuroblastoma

Access Case Critique to view:

  • Appropriate diagnosis
  • Critique
  • References

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