Tumour board presentation 22.03.24.pptx

tumour board presentation of aiims bhopal in which those cases are discussed which have no clear cut course of treatment

1. Tumor Board Meeting Dr. Shashank Bansal Assistant Professor Department of Medical Oncology and Hematology AIIMS, Bhopal (MP) Email: [email protected]

2. Case 65 year old female presented with complains; Altered bowel habits x 2 years Occasional Bleeding PR x 6 months Pain while passing stools x 3months No history of Fever,night sweats, weight loss, joint pains No comorbidities No Significant Family history Examination: PS 1 Pallor +/ Icterus -/Clubbing -/Cyanosis- P/A: Soft Nontender P/R: ulceroproliferative mass at anal verge, Tenderness present, upper extent cannot be evaluated because of pain

3. Evaluation Viral markers: Negative Colonoscopy 12/01/24: UPG 10 cm from anal verge PET-CT Scan (30/01/2024) (Max Delhi): Enlarged node at Left level IV cervical and left supraclavicular region [1.6x0.9][SUVmax 6.9] Prevascular, left paratracheal and left hilar [2.6 x1.5 cm] [SUVmax 10.0] Peripancreatic,periportal, paracaval, aortocaval, preaortic, and left paraaortic [2.1x 1.1 cm][SUVmax 9.0] Multiple perirectal LN [9x7 mm] [SUVmax 2.3] Circumferential thickening in the lower rectum and anal canal [length 6.5 cm, thickness 2.5 cm, SUVmax8.0]

4. Source: AJCC 8th Edition TNM stagingTextbook

5. Histopath FNAC periportal LN [05/02/24][Max Delhi] : Granulomatous Lymphadenitis Biopsy Review [02/03/2024][AIIMS bhopal][block:240224HP02462] : Squamous cell Carcinoma FNAC Left Supraclav LN [240315FN0943][AIIMS Bhopal]: lymphnode shows few granulomas composed of epitheloid cells, histiocytes, macrophages and lymphocytes. background shows polymorphous lymphoid cells and numerous RBCs. Impression: Granulomatous lesion CBNAAT: Negative AFB staining: No AFB seen

6. Persistent Genralised Lymphadenopathy : Enlarged , non-tender, lymphadenopathy in 2 or more non-contiguous locations, for more than three months.

7. Discussion Cause of granulomatous lesion? Should the LNs be considered metastatic? Further Management?