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Current cases & concepts
The Clsvelanc Clime ClevelanfJ, Ohto
Foundation.
A f&year-o!d white female prcseotrd to the Cleveland Clinic because of anemia. Tb: patient had been followed by her hmdy physician for the pas; 5 years for aoemin: shhe previously had a ri,ght hemiwlectomy in L972 for adamcarcinoma. In ~recent months tbc patient’s he lobin bad wnfinued b&n notmal. A&r transfurion her hemoglobin had risen to Ii bu! subsequently fell to 7 g. prescmably because of en. tcric blood Iosr. A stool gudac was positive on several occarionr. On prwentation BI an wtpatient at the Clew land Clinic the paiient had a Delta scan 2 weeks
guided biopsy was wformed with a U-gauge nwdk for aspiration Ikcaux the nwss was intimately 8s. sociatfed with the colon and we did not believe rha: a cutting needle could be employed safely. As WDI. anticipated by the radiologist performing the biopsy, an adequate specimen was not obtained and only a small amount of fluid was recovered. Cheracteri~ ticallj, in thaw instances. biopsies are not positiw unless one is able to obtain P pardon of the wall or stromal cells. EJwwse of this, ths patient was tabo to surgery. At surgery B large ntropcritanrd nuw in the same location as noted on the CT wsn was found. Under direct visurllz@ion B Vim Silvermsn ntxdte was used to biopsy the lcrion and the rpcimen yielded malignant cells consiacilt with mucinour cmcinomr.
Foundation.
A f&year-o!d white female prcseotrd to the Cleveland Clinic because of anemia. Tb: patient had been followed by her hmdy physician for the pas; 5 years for aoemin: shhe previously had a ri,ght hemiwlectomy in L972 for adamcarcinoma. In ~recent months tbc patient’s he lobin bad wnfinued b&n notmal. A&r transfurion her hemoglobin had risen to Ii bu! subsequently fell to 7 g. prescmably because of en. tcric blood Iosr. A stool gudac was positive on several occarionr. On prwentation BI an wtpatient at the Clew land Clinic the paiient had a Delta scan 2 weeks
guided biopsy was wformed with a U-gauge nwdk for aspiration Ikcaux the nwss was intimately 8s. sociatfed with the colon and we did not believe rha: a cutting needle could be employed safely. As WDI. anticipated by the radiologist performing the biopsy, an adequate specimen was not obtained and only a small amount of fluid was recovered. Cheracteri~ ticallj, in thaw instances. biopsies are not positiw unless one is able to obtain P pardon of the wall or stromal cells. EJwwse of this, ths patient was tabo to surgery. At surgery B large ntropcritanrd nuw in the same location as noted on the CT wsn was found. Under direct visurllz@ion B Vim Silvermsn ntxdte was used to biopsy the lcrion and the rpcimen yielded malignant cells consiacilt with mucinour cmcinomr.