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File:IPLab7Metastatic9.jpg|This is a high-power photomicrograph of the edge of the tumor nodule in the lung. The tumor cells area growing in a glandular pattern. The area of necrosis is evident at the right side of the image.
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== Virtual Microscopy ==
=== Lung ===
<peir-vm>IPLab7Metastatic_Lung</peir-vm>
=== Liver ===
<peir-vm>IPLab7Metastatic_Liver</peir-vm>
== Study Questions ==
* <spoiler text="What are the most common sites of metastasis for primary adenocarcinomas of the colon?">All colorectal tumors spread by direct extension into adjacent structures and by metastasis through the lymphatics and blood vessels. In order of preference, the favored sites of metastatic spread are the regional lymph nodes, liver, lungs, and bones, followed by many other sites, including the serosal membrane of the peritoneal cavity, brain, and others. Generally the disease has spread beyond the range of curative surgery in 25 to 30% of patients.</spoiler>
* <spoiler text="What are some clues which suggest that these are metastatic tumors rather than primary tumors?">The lesions are spread throughout both the liver and the lung and they are variably-sized. There does not appear to be a large primary tumor with multiple small "daughter tumors." Of course these only suggest metastasis. To be sure of the source of the tumor immunohistologic stains for specific diagnostic markers would be performed on the tissues to determine the tissue of origin.</spoiler>
== Additional Resources ==
=== Reference ===
* [http://emedicine.medscape.com/article/367061-overview eMedicine Medical Library: Imaging in Adenocarcinoma of the Colon]
* [http://emedicine.medscape.com/article/277496-overview eMedicine Medical Library: Colon Adenocarcinoma]
* [http://www.merckmanuals.com/professional/gastrointestinal_disorders/tumors_of_the_gi_tract/colorectal_cancer.html Merck Manual: Colorectal Cancer]
* [http://www.merckmanuals.com/professional/hepatic_and_biliary_disorders/liver_masses_and_granulomas/metastatic_liver_cancer.html Merck Manual: Metastatic Liver Cancer]
=== Journal Articles ===
* Castro CY, Moran CA, Flieder DG, Suster S. [http://www.ncbi.nlm.nih.gov/pubmed/11683941 Primary signet ring cell adenocarcinomas of the lung: a clinicopathological study of 15 cases]. ''Histopathology'' 2001 Oct;39(4):397-401.
=== Images ===
* [{{SERVER}}/library/index.php?/tags/219-adenocarcinoma PEIR Digital Library: Adenocarcinoma Images]
* [{{SERVER}}/library/index.php?/tags/415-metastatic_adenocarcinoma PEIR Digital Library: Metastatic Adenocarcinoma Images]
* [http://library.med.utah.edu/WebPath/LIVEHTML/LIVERIDX.html#4 WebPath: Hepatic Neoplasms]
* [http://library.med.utah.edu/WebPath/LUNGHTML/LUNGIDX.html#8 WebPath: Lung Neoplasms]
== Related IPLab Cases ==
* [[IPLab:Lab 7:Adenocarcinoma|Lab 7: Colon: Adenocarcinoma]]
* [[IPLab:Lab 7:Lip SCC|Lab 7: Lip: Squamous Cell Carcinoma]]
* [[IPLab:Lab 7:Esophagus SCC|Lab 7: Esophagus: Squamous Cell Carcinoma]]
* [[IPLab:Lab 7:IDC|Lab 7: Breast: Infiltrating Ductal Carcinoma]]
* [[IPLab:Lab 7:Bronchogenic Carcinoma|Lab 7: Lung: Bronchogenic Carcinoma]]
{{IPLab 7}}
[[Category: IPLab:Lab 7]]