Case 187

Surgical Pathology Case


  42-year-old male, frequent lower GI bleeding for three years with the hemoglobin low of 3.2 that required multiple transfusions. Totally nine EGD and colonoscopies failed to find any source of bleeding. A recent Tc 99 tagged RBC study revealed a source of intermittent hemorrhage in the distal small intestine. A Meckel's scan also identified this location with gastric activity, and therefore a clinical diagnosis of Meckel's diverticulum was made. A partial small bowel resection was performed.



The specimen consists of one segment of small bowel measuring 13.0 cm in length. The central part of the specimen is significantly enlarged measuring 7.0 6.0 6.5 cm.  Sectioning through the specimen reveals a gray-yellow tumor involving the entire circumference and thickness of the small intestine. The tumor measures 9.0 cm in circumference, 7.0 cm longitudinally and 3.0 cm in greatest thickness.



HE, 2

HE, 4


HE, 10

HE, 20


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Source: Department of Pathology, Creighton University Medical Center, Omaha, NE

Photo: Zenggang Pan

Discussion: Zenggang Pan