title: Medullary colon cancer presenting with total necrosis of all regional lymph node metastases: morphologic description of a presumed immune-mediated event.
abstract: Medullary carcinoma is a rare type of colon cancer with characteristic clinical and molecular features. Notably, despite its high-grade histology, the prognosis is generally better than for colonic adenocarcinoma of the usual type. We present herein a singular case of medullary colon cancer in which all of numerous lymph node metastases in the surgical resection specimen were completely necrotic in the face of a wholly viable primary tumor. Possible mechanisms are discussed with emphasis on immune-mediated factors.Virtual Slides: The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/13000_2014_204.
authors.affiliation: Department of Anatomic Pathology and Cytology, Maisonneuve-Rosemont Hospital, 5415 Boulevard de L'Assomption, Montreal H1T 2M4, Quebec, Canada. plaines@me.com.
authors.forename: Andrew
authors.initials: A
authors.lastname: Mitchell
authors.forename: Yves
authors.initials: Y
authors.lastname: Bendavid
mesh_terms: D000368:Aged; D018276:Carcinoma, Medullary / Q000276:immunology / Q000473:pathology* / Q000601:surgery; D003106:Colon / Q000473:pathology; D003110:Colonic Neoplasms / Q000276:immunology / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis; D009336:Necrosis; D011379:Prognosis; D046888:Tissue Array Analysis; D016896:Treatment Outcome