colon cancer 환자 Right hemicolectomy 시행하여 다음과 같은 병리결과가 나왔습니다.Colon, terminal ileum and appendix, right hemicolectomy :- Poorly differentiated carcinoma, consistent with adenocarcinoma, poorly differentiated with neuroendocrine components and signet ring cell component, 9.5x5.5x2.0cm, transverse colon (See comment)   with 1) invasion depth: pericolic adipose tissue         2) lymphovascular invasion: present            - small vessel lymphovascular invasion: present           - Intramural venous invasion: not identified           - extramural venous invasion: not identified        3) perineural invasion: not identified        4) tumor budding: low score (0-4)        5) clear proximal and distal resection margins           safety margins: proximal 11.5cm, distal 16.5cm        6) no metastasis in 22 lymph nodes            : pericolic ; 0/19, r/o metastatic LN ; 0/1, mesenteric LN ; 0/2        7) tumor deposit : not identified        8) pathologic stage: pT3N0 (AJCC, 8th)- Adenocarcinoma, moderately differentiated, ascending colon, 2.5x2.4x0.8cm   with 1) invasion depth : muscularis propria        2) lymphovascular invasion : present           - small vessel lymphovascular invasion: present       3) perineural invasion : not identified       4) tumor budding : intermediate score (5-9)       5) clear proximal and distal resection margins- Appendix, hyperplastic polyp [COMMENT]Tumor consists of neuroendocrine morphology with focal positive for synaptophysin and negative for CD56, and chromogranin immunohistochemistry. Mixed adenoneuroendocrine carcinoma can be considered, however immunohistochemical result is not definite. Clinicopathologic correlation is recommended. [MOLECULAR PATHOLOGY]M24-000217      EBV in situ hybridization       [검사결과]EBV in situ hybridization  : negative in slide 1-4=> 질문* 질문 1morphology 문의드립니다. 8574/3 : Carcinoma with neuroendocrine differentiation 8244/3 : Mixed adenoneuroendocrine carcinoma 8140/3 : Adenocarcinoma제가 찾아보았을때 위와같이 나오는데이중에 T-colon은 8574/3 , A-colon은 8140/3 으로 각각 암등록 하는 것이 맞나요?(동일조직소견군이 아님)*질문 2혹시 T-colon 부위에 더 적합한 mophology 가 8244/3 이라면, A-colon과 동일 조직소견군으로 보이는데 이경우 원발부위는 T-colon과 A-colon 중에 어느것으로 해야하는지도 문의드립니다. 담당의사가 둘중 원발부위를 따로 정하지 않는다면 C189 로 원발을 주면 되는 것일까요?감사합니다.
해당케이스는 아래와 같이 동일장기군, 동일조직소견군으로 'C18.9 M8140/3' 으로 한번만 등록합니다.- transverse colon: M8140/3(adenocarcinoma)- ascending colon: M8140/3(adenocarcinoma)