Female 74 years

Small intestine. Long history of NSAID use.

Macro: 130mm length of small bowel focal ulceration and separate triangular shaped indentation of the mucosa measuring 10 x 10mm Block from representative section of triangular indentation, blocks from elsewhere show ulceration typical of NSAID related injury.

Specials: None.

Female 74 years

Large intestine. History of diverticulitis. Vomiting, and diarrhoea Metronidazole for C diff but later stopped. Sigmoidoscopy showed "odd patern" of colitis. CT indicated pancolitis. Started on prednisolene Endocsopic biopsies from flex sig reported as acute pattern of colitis suggestive of infection (includeing C diff) or ischaemia. Patient discharged but deteriorated. Readmitted for emergency laparotomy.

Macro: Mucosal surface coated with discrete but generally non-confluent pale fibrinous pseudomembranes throughout colon.

Specials: None.

Female 73 years

Oesophagus. Ivor Lewis gastro-oesophagectomy with tumour at 33cm. T2N0 at EUS, 2 cycles neoadjuvant chemo.

Macro: Ivor-Lewis oesophagogastrectomy. Tumour 44mm long. The tumour has a clearance of at least 14mm from the gastric resection margin and 38mm from the proximal resection margin.

Specials: ABPAS, p63, CK5, EMA, CK7, BEREP4 postiive, CK20, CDX2, AFP negative.

Male 80 years

Small intestine. Resection. Distal small bowel. RIF Pain - Abdominal distension. Localised peritonitis.

Macro: Small intestine measuring 66.9cm in length and up to 3.4cm in diameter. The small intestine mucosa and wall shows patchy discolouration with congestion and haemorrhagic areas present in the middle of the specimen for a length of 26.1cm. A congested area is present 6.0cm from the closest longitudinal stapled margin. The serosal surface is congested and has areas of fibrin present on it. There is a staple line along the length of part of the mesentery. No perforation is seen. Additionally there is an ulcerated area of exudate on the surface of the mucosa measuring 6cm in maximum diameter 18.0cm from the closest longitudinal margin.

Specials: None.

Female 59 years

Large intestine. Peritoneal studding with what looks like cancer. Biopsies of peritoneum + omentum. Differential TB.

Macro: Described and labelled as: "omentum". A piece of firm, haemorrhagic, fatty tissue measuring 35 x 30mm and up to 14mm in thickness. On slicing, no focal lesions identified.

Specials: ZN and Grocott stains were negative.

Male 24 years

Small intestine. Acute abdomen ?appendicitis. On imagimg ? Meckel's diverticulum.

Macro: A blind ended diverticulum with one stapled margin. The specimen measures 20 x 50 x 20mm. Serosal surface covered with fibrinous exudate.

Specials: None.

Female 11 years

Appendix. Two months RIF pain. Thickened appendix at surgery. ?carcinoid ?chronic appendicitis.

Macro: oval piece of tissue measuring 70 x 20mm. A segment of appendix is seen projection from the centre 25 x 10mm. Appendix measuring 50mm in length. Mucosa shows two separate dense yellow areas measuring 5mm and 20mm. Section provided is from the smaller yellow focus.

Specials: Tumour shows positive expression for MNF116, CD56, chromogranin and synaptophysin. The proliferation fraction on staining with MIB 1 is less than 2%.

Male 69 years

Small intestine. Massive splenomegaly and pancytopenia. Small bowel perforation. ?mesenteric mass, Splenectomy and small bowel resection.

Macro: 2. Small bowel 80mm in length and 40mm in maximum diameter. The wall is thickened, especially so in the central 40mm. In this thickened area, which appears circumferential, there is loss of the normal mucosl pattern and through it there is a perforation that appears to be at least 20mm in length and is over sewn. On section there is a tumour that is solid, pale and 'flesh-like', but which is poorly-demarcated and replaces normal bowel structure.

Specials: CD3 CD8 cytotoxic markers TIA 1 and granzyme-B positive, CD5, CD2 and CD4 CD30 EBER / EBV negative. 30% of cells proliferating (MIB-1immunostain). CD56 is only weakly positive.

Male 65 years

Large intestine. Low rectal cancer tethered to coccyx. Laparoscopic ELAP with excision of coccyx. Short course radiotherapy.

Macro: Site of tumour- Rectum. Maximum tumour diameter- 38mm. No tumour perforation - Relation to peritoneal reflection- 60mm below. Distance from dentate line- 20mm. The attached coccyx measures 20 x 10 x 15 mm. TME -3 ELAP- 3. Tumour to high tie distance 210mm. CRM 12 mm. No definite high tie node identified.

Specials: None.

Male 63 years

Stomach. Distal gastric cancer. Neoadjuvant chemotherapy.

Macro: Subtotal gastrectomy measuring 24cm along greater curve and 10cm along lesser curve. There is thickening in the distal stomach measuring 7.4 x 4cm.

Specials: Section is from thickened area of stomach.

Male 39 years

Complaining of reflux-type symptoms. OGD does not show oesophagitis. Random oesophageal biopsies taken.

Male 57 years

Presented with dysphagia. Previous fundoplication. Large gastro-oesophageal junction tumour surgically resected. No neo-adjuvant therapy. The entire tumour has been blocked. The presented slide derives from the distal end of the tumour but is histologically similar to all the other tumour blocks.

Male 55 years

Resection of oesophageal stricture.

Female 62 years

Oesophagectomy - extensively dilated (up to 6.5cm in diameter) with a polypoid tumour. Sections of background oesophageal wall and of the tumour provided.