2.5.1.

Clinical diagnosis: Carcinoma recti

Character of operation: Resectio rectosigmae
Object of investigation: Fragment of large intestine
Macroscopical description: 25 cm large intestine, in which in 5,5 cm distance from one
resective edge detected circulary growing tumor, composed from gray and fragil tissue, with
thickness of 2 cm. Beside tumor, in mesenterium detected alike previous nodus structure other
nodus in diameter 3 cm, possibly composed from lymphnodes.
Histological description: Tumor detected in removed intestine is composed of atypical
glandular structures located in abundant fibrous stroma with mixed inflammatory infiltration.
Surface of tumor is ulcerating. Neoplastic glands also detected in perirectal tissue, no neoplastic
infiltration into peritoneum. Inflammatory infiltration established inside fatty tissue of mesenterium.
Neoplastic infiltration detected in 4 from 20 investigated lymphnodes (biggest lymphnod 1,8 cm
in diameter). No neoplastic infiltration in resective edges of intestine.
Conclusion/diagnosis ...........................................................................

2.5.2. Clinical diagnosis: Carcinoma prostatae

Character of operation: Resectio prostatae radicalis
Object of investigation: Prostate with semen vesicules
Macroscopical description: 4x5,5x4 size prostate, modular in erossections with small
yellow foci in left lobe.
Microscopical description: Infiltratively growing tumor, composed of separated small
neoplastic glands detected in both lobes of prostate. Semen vesicules without neoplastic infiltration.
Also no neoplastic infiltration into resective edges and periprostatic tissue.
Conclusion/diagnosis ...........................................................................

2.5.3. Clinical diagnosis: Carcinoma ducti choledochi, icterus mechanicus

Character of operation: Cholecystectomia, lymphonodectomia, biopsia hepatis
Object of investigation: 1. Biopsy from liver; 2. Gall bladder; 3. Lymphnodes
Macroscopical description: Nr1 2 till 0,7 cm in diameter gray and pale fragments of
tissue; Nr2 8 cm in diameter gall bladder with abundant till 1 cm diameter calculi; thickness of
wall till 1,3 cm, yelow; Nr 3 3x0,5 cm size fat tissue fragment.
Microscopical description: Nr1 fragments of liver tissue in which detected massive
neoplastic infiltration. Neoplastic tissue composed of small atypic glandular structures and

separated atypical polymorphic cells; Nr2 masissive neoplatic infiltration of middle and fundus
gold bladder wall, extending into all layers. Tumor composed of small glandular structures and very
polymorphic atypical epithelial cells. Tumor spreads perineuraly, detected tumorous thrombi in
veins, no neoplastic infiltration in resective edge of bladder collum. Nr 3 normal structure of fat
tissue fragment.
Conclusion/diagnosis ...........................................................................

2.5.4. Clinical diagnosis: Carcinoma intestini crassi

Character of operation: Hemicolectomia sinistra et resectio rectosigmae
Object of investigation: Sigmoid intestine and two nodes
Macroscopical description: Received 48 cm fragment of large intestine with 43x4x3 cm
size fatty mesenterium. In central part of intestine detected ulcerated tumor, 9 cm long, infiltrating
about 60 % of wall, nearly totally occluding lumen of intestine. Tumor infiltrates mesenterium,
thickenate wall till 4 cm, in some places grows circulary, one edge of intestine very hard with 5
small clear lymphnodes within, lumen of intestine stenosated.
Microscopical description: Tumor of intestine is composed of polymorphic, well
differentiated, partim cysticaly dilated glandular structures, glands composed of monomorphic,
forming more layers neoplastic cells. Number of mitoses scant, expressed stromal immune
response. Tumor infiltrate all layers of intestine wall and grows into surounding fatty tissue. No
malignant infiltration in detected 15 lymphodes. In the hard fragment of intestine proliferate fibrous
tissue without neoplastic and inflammatory infiltration.
Conclusion/diagnosis ...........................................................................

2.5.5. Clinical diagnosis: Carcinoma colonis sigmoidei

Character of investigation: Fragment of sigmoid colon
Macroscopical description: 21 cm long fragment of intestine in wich central part, in 1 cm
diameter circulary grows tumor, forming of 0,8 thickness gray tissue.
Microscopical description: Growing tumor composed of moderate size, atypical cells,
deposited in moderatedly expressed fibrous stroma. Surface of tumor ulcerating, tumor infiltrate all
layers of intestine and visceral peritoneum; noticed perineural spreading. Lymphnodes metastases
detected in 2 from 10 investigated lymphodes (biggest 0,6 cm).
Conclusion/diagnosis ...........................................................................

2.5.6. Clinical diagnosis: Carcinoma ventriculi

Character of operation: Resectio ventriculi subtotalis et resectio colonis transversi

Object of investigation: Part of stomach with tumor and colon transversum
Macroscopical investigation: Received part of stomach, 14 cm long through small
curvatura and 20 cm on large together with 18x22x2 size major omentum and 4 cm size minor
omentum part. In stomach curvatura major, 7 cm distant from pyloric resected edge detected 5,5 cm
in diameter ulcerating tumor, composed of moderate size, with basophilic cytoplazma cells which
locate as solid areas, in other areas primitive glands. Moderate lymphocytic infiltration of stroma.
Tumor cells totaly infiltrate all layers of stomach wall, but no infiltration into removed intestine
wall. Metastases detected in 3 from 25 investigated lymphnodes (2 from 14 in major omentum, 1
from 7 of minor, 0 from 4 separatedly received), biggest lymphnode 0,8 cm in diameter. No
neoplastic infiltration of resective edges of stomach wall.
Conclusion/diagnosis ...........................................................................

2.5.7. Clinical diagnosis: Carcinoma esophagi

Character of operation: Resectio esophagi
Object of investigation: Fragment of esophagus
Macroscopical description: 13 cm esophagus and 7 cm long stomach fragments, sectioned
in middle, with stent inside esophagus. 7 cm distant from resective esophagus edge in 8 cm long
ness wall of esophagus is thicker till 1,3 cm. Thickening ocupates approximatedly 1/3 lumen, in
other areas mucosis reddich with impression of stent. In stomach 8 cm long operative section, no
other morphological changes.
Microscopical description: in the place of thickened esophagial wall detected tumor,
composed of solid nests with oval, pale, basophylic nuclei, abundant eosinophylic cytoplama and
intracytoplasmatic keratinisation cells. Small necrotic areas detected. Tumor cells grow through
muscular layer and infiltrate surounding fatty tissue, spread perineuraly, into lymph vessels and
veins. No neoplatic infiltration into 5 detected lymphnodes of fatty tissue. Mucosis of stomach
unchanged.
Conclusion/diagnosis ...........................................................................

2.5.8. Clinical diagnosis: Carcinoma renis dextri

Character of operation: Nephrectomia dextra
Object of investigation: Kidney

Macroscopical description: 12x7x7 cm size kidney, sectioned in leteral surface.

Circumscribed, clearly yellow nodus detected in upper part of kidney. Tumor capsule attached to
surrounding fatty tissue, suspicion of tumor growing into fatty capsule, kidney veins empty.
Microscopical description: Detected tumor composed of moderate size cells with light
cytoplasma and small hyperchromatic nuclei; neoplastic cells form trabecular and alveolar
structures. Tumor cells infiltration into fatty capsule established.
Conclusion/diagnosis ...........................................................................

2.5.9. Clinical diagnosis: Carcinoma vesicae urinariae

Character of operation: Resectio vesicae urinariae transurethralis
Object of investigation: Nodules of tumor
Macroscopical description: Lots of small gray masses (all diameter 2 cm)
Microscopical description: Papillary structures covered with slightly atypic transitional
epithelium without expressed mitotic activity, no invasion into subepithelial and muscular layers.
Conclusion/diagnosis ...........................................................................