COLON & RECTUM - Ulcerative colitis with dysplasia and carcinoma

The specimen consists of the large intestine from caecum to anus. The greater part of the colon shows fissuring, ulceration, and polyposis. The bowel wall is markedly thickened. The distal 15.0 and 20.0 cm shows an extensive ulcerating carcinoma. Histologically the appearances were those of ulcerative colitis with polyposis and marked dysplasia. The carcinoma is a mucus-producing adenocarcinoma infiltrating lymphatics. 101 lymph nodes were found with the specimen; none showed tumour infiltration.
This man presented at the age of 72 with a 27-year history of ulcerative colitis which had been more or less well controlled. He had three to four bowel motions a day with some mucus but over the previous six months had had an increasing frequency of bowel motions together with more recently, the passage of fresh blood.