Male 45 years

Small intestine. Jejunal stricture with multiple mesenteric lymph nodes extending to SMA.

Macro: Segment of small bowel 410mms. The bowel wall is puckered 130mm from on end. On opening the specimen, the puckered area is stenosed due to a circumferential tumour 15mm wide.

Specials: Tumour cells are CK7 positive and CK20 positive. Chromogranin and synaptophysin are negative.

Female 73 years

Large intestine. Recent admission with viral gastroenteritis. Weight loss continues. Previous left upper lobectomy for cancer in 2012. Monoclonal gammopathy. Rheumatoid arthritis. PBC. At endoscopy diverticular disease in the descending to sigmoid colon. Two sessile polyps, the largest 4 mm excised from the rectum. No other pathology seen.

Macro: Rectal polyps. Several fragments, the largest 4mm in max. dimension.

Specials: PAS positive.

Female 89 years

Stomach. Iron deficiency anaemia.

Macro: Three fragments, up to 3.5 mm.

Specials: Perl's positive material.

Female 74 years

Large intestine. Polypectomy from distal sigmoid.

Macro: 27mm polyp, small stalk 2mm length identified.

Male 39 years

Appendix. Colon. Colectomy for colitis.

Macro: A colectomy specimen 730 mm in length, with a short length of terminal ileum 23 mm, and attached appendix 43mm. The distal 300 mm of this colon shows the mucosa to be erythematous, haemorrhagic with adherent fibrin with some superficial ulceration seen focally. There is loss of the normal mucosal folds. The proximal ascending colon, caecum, appendix and ileum appear within normal limits.

Specials: Histology of the distal colon shows moderately active ulcerative colitis. The proximal colon, and short segment of terminal ileum are not involved.

Female 64 years

Stomach. Polyp intussucepting into duodenum. Causing gastric outlet obstruction. No previous biopsy. Full thickness excision from gtr curve.

Macro: Gastric greater curve polyp: polypoidal gastric mucosa measuring 62 x 72 x 30mm, mucosal surface is ulcerated with fibrinous exudate on the surface over an area measuring 66 x 17mm, yellow homogenous cut surface, no areas of necrosis or haemorrhagic degeneration.

Specials: Lesion positive for S100, negative for HMB45, Melan A and CD117. CD34 highlights vessesl, SMA and desmin stain highlights perivascular smooth muscle, proliferation marker Ki67 is very low.

Male 78 years

Stomach. Adenocarcinoma of distal stomach with gastric outlet obstruction.

Macro: A distal gastrectomy specimen. There is a tumour palpable within the pylorus, circumferential and occludes the gastric outlet, 38 x 20 mm, involving a length of stomach of 46 mm. There is considerable surrounding fibrosis The serosal surface around the distal end of the stomach in the region of the tumour shows some erythema and pinpoint haemorrhage but there is no obvious serosal involvement by tumour.

Female 59 years

Gall bladder. Gall stones.

Macro: Gall bladder 60 x 40 x 30 mm. Towards the distal end there is a white and yellow nodule 20 x 25 mm. On sectioning the gallbladder contains numerous stones up to 5 mm diameter. At the fundus there is a thickened area 20 x 15 mm. The rest of the wall measures up to 2mm in thickness. Histology taken of the fundus.

Specials: Larger cells CEA positive (100%) of cells. Strong positive CK7 CAM 5.2 and CD10. MiB1 >90%Chromogranin and Synatophysin weakly positive. Smaller cells CEA and CK7 negative. Weak positive CAM 5.2 and CD10. MiB1 30%. Chromogranin and Synatophysin strongly positive.

Female 33 years

Large intestine. Right hemicolectomy. ?Carcinoid from mesentery. ?GIST.

Macro: Right hemicolectomy specimen. Included in the mesentery is a firm, brown, ragged-surfaced mass measuring 58 x 48 x 35mm. The separate loop of small bowel, length 380mm, is attached to the left edge of the mass, the right edge of which faces towards the ileocaecal junction. Opening the separate length of small bowel reveals intact mucosa which is tethered for a length of 20mm overlying the mass.

Specials: The lesion shows weak cytoplasmic positivity for beta-catenin. Negative immunostains are: CD117, DOG-1, CD34, SMA, desmin, S100 and AE1/AE3.

Female 61 years

Large intestine. Ischaemic caecum. Thickened mesocolon with lymph nodes. ?lymphoma.

Macro: Right hemicolectomy with darkened mucosal patches in caecum and thickened wall.

Specials: MNF116, ER and PR positive.

Female 73 years

Small intestine. Past medical history of myelodysplasia. Recent hernia repair. Presented with small bowel obstruction. Band adhesion and multiple mesenteric nodules noted at laparotomy.

Macro: 160mm length of small bowel with a fibrous stricutre at the distal end and multiple nodules up to 12mm along the mesentery.

Specials: Focal positivity with CD42b and myeloperoxidase.

Male 62 years

Large intestine. Ascites and multiple peritoneal nodules with thickening on CT scan. Appendices epiploicae removed at laparoscopy.

Macro: Fatty tissue 20 x 10mm.

Specials: Pankeratin and calretinin +ve BerEP4, CK7, CDX-2, CK20 negative.