Gastroenterology Research, ISSN 1918-2805 print, 1918-2813 online, Open Access
Article copyright, the authors; Journal compilation copyright, Gastroenterol Res and Elmer Press Inc
Journal website https://www.gastrores.org

Case Report

Volume 14, Number 3, June 2021, pages 194-198

Colonic Ganglioneuroma: A Rare Lesion With Extremely Different Presentations and Outcomes in Two Patients

Figures

Figure 1.
Figure 1. Colonoscopy image in the ascending colon with arrow pointing at obstructing mass.
Figure 2.
Figure 2. Colonoscopy image in the descending colon with multiple arrows pointing at multiple polyps.
Figure 3.
Figure 3. Poorly differentiated adenocarcinoma with signet ring cell features (H&E, original × 400). H&E: hematoxylin and eosin stain.
Figure 4.
Figure 4. High-grade neuroendocrine carcinoma (H&E, original × 400). H&E: hematoxylin and eosin stain.
Figure 5.
Figure 5. High-grade neuroendocrine carcinoma with Ki67 proliferative index = 40% (Ki67 immunostain, original × 200) with multiple black arrows showing KIT positivity.
Figure 6.
Figure 6. Ganglioneuroma with neuromatous stroma and dispersed ganglion cells (H&E, original × 100). H&E: hematoxylin and eosin stain.
Figure 7.
Figure 7. Mixed adenocarcinoma high-grade neuroendocrine carcinoma in metastatic liver lesion (H&E, original × 400). H&E: hematoxylin and eosin stain.

Table

Table 1. Initial relevant Laboratory Values on Presentation
 
Laboratory testResult (normal range), day 1Result (normal range), day 2
Hemoglobin12.3 g/dL (12 - 16 g/dL)11 g/dL (12 - 16 g/dL)
Hematocrit36.6% (42-51%)33% (42-51%)
Leukocyte count13,300/µL (4,800 - 10,800/µL)12,800/µL (4,800 - 10,800/µL)
Platelet count239,000/µL (150,000 - 400,000/µL)209,000/µL (150,000 - 400,000/µL)
Blood urea nitrogen9 mg/dL ( 8 - 26 mg/dL)9 mg/dL (8 - 26 mg/dL)
Serum creatinine0.8 mg/dL (0.5 - 1.5 mg/dl)0.8 mg/dL (0.5 - 1.5 mg/dL)
Serum albumin3.9 g/dL (3.2 - 4.6 g/dL)3.4 g/dL (3.2 - 4.6 g/dL)
Serum total bilirubin2.1 mg/dL (0.2 - 1.1 mg/dL)1.6 mg/dL (0.2 - 1.1 mg/dL)
Alkaline phosphatase45 U/L (43 - 160 U/L)36 U/L (43 - 160 U/L)
Serum alanine aminotransferase14 U/L (5 - 40 U/L)12 U/L (5 - 40 U/L)
Serum aspartate transaminase18 U/L (9 - 36 U/L)14 U/L (9 - 36 U/L)
Lactic acid level2.0 mmol/L (0.5 - 1.6 mmol/L)1.3 mmol/L (0.5 - 1.6 mmol/L)