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The Old Endoscopy Quiz (and Answer) of the Month
January 2008

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the Quiz Page

Question:

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This gentleman in his upper middle age was found to have multiple metastatic lesions in his liver. His only symptom was a quite severe fatigue which had bothered him for a few weeks. A colonoscopy was made and this ins the finding in the caecum, just behind the ileocaecal valve in the regions where the appendix aperture usually is located. The tumour markers CEA and Ca 19-9 were very closely to normal. What is this finding?

Correct answer:

    This lesion was supposed to be a malignant carcinoid tumour, but it was not. Chromogranin A was normal and so was 5-HIAA-urinary collection. Histologically this tumour was a malignant sarcoma, and it was not possible to differentiate between the different types of sarcomas from the small biopsy samples. But, it could have been a carcinoid, as very many of You have suggested, and these answers are considered correct. It is of course not possible to make a microscopic diagnosis on a macroscopic finding.

Correct answers and comments were emailed by

    Cheryl Lynch, Erie, USA/PA
    Dr.Virendra Parikh, Fort Wayne, USA,, Indiana
    AYYAKANNU KUMAR, Brentwood, UNITED KINGDOM
    VANDERLEI LIMA, SÃO SEBASTIÃO DO PARAISO - MG, BRASIL
    BURHAN TAM, Esenyurt- İSTANBUL, TÜRKİYE
    Hakan YAPICI, ISTANBUL / ESENYURT, TÜRKİYE
    FernandoPeres, Rio de Janeiro, Brazil
    Albert & Trinh Chang, Redlands, CA
    DR. MAHDI ALJAROUDI, KHOBAR, Kingdom of Saudi Arabia
    ERDEM ULUCAY, İSTANBUL, TURKEY
    Lavrentios Papalavrentios, Thessaloniki, Greece
    PARABOLI DA SILVA , Marcio Luiz M.D, SAO JOSE DO RIO PRETO, BRAZIL
    Karakoidas Christos, Athens, Greece
    engin yildirim, TEKİRDAĞ YAŞAM HASTANESİ
    UMUT TİRYAKİ, TEKİRDAĞ, TÜRKİYE
    Adrian Wró¿ek, 28-100 Busko-Zdroj, Poland
    Jukka Karvonen, Turku, Finland
    Mary Alizadeh, Jacksonville, Florida, USA
    luisguillermoguerrero, Bogota, Colombia
    Fabrizio Cereatti Gianfranco Fanello, Rome, Italy
    Danilo Trifogli, Rome, Italy
    Cevale Karslioglu Sgouros, Istanbul, Türkiye


    Rio de Janeiro, Brasil
    Gustavo Pignaton, Rio de Janeiro, Brasil
    Yankov, Sofia, Bulgaria
    osman demirkol, Istanbul, Türkiye
    Deena Brooks, New Lowell, Ontario, Canada
    sheeja dhanesh, Manchester, England
    Goran Ribic, Pula, Croatia
    rashedhassen, fakous, Egypt
    Mehmet Gök, Kayseri, Turkey
    Noa Ciuraru, Kfar- Saba, Israel
    Dr.Jaber Badran, Dayr Azzour, Syria
    ESIN KABUL, ISTANBUL, TURKEY
    CHITRA, CHENNAI, INDIA/TAMILNADU
    Reza Alami, Gotenbourg, Sweden
    MAJID HOSSEINIAN, TEHRAN, IRAN
    venkata pokkunuri, Losangeles, USA/California
    Dr.Arber Veliu, Prishtina, Kosovo
    jawad, hamilton,ontrario,Canada
    Jose Dondis, Panama, Panama
    ABİT DEMİRCİ, Esenyurt-İSTANBUL, TÜRKİYE
    German Lloret Salom, Alzira, Spain
    Lazuchiewicz-Kot Malgorzta, Lodz, Poland
    mario galluzzi, lecco, Italy
    Jennifer Brenner, Houston, USA

Comments:

    I would like to thank you very much for showing an image from Kosovo, The National Public Library .
    I use this opportunity to Wish you and your staff the very Happy New Year and all the best always

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February 1, 2008