Kyung Hee University, Seoul, Korea Conference LGI Conference Presented by Byeong-Joo Noh Supervised by Youn-Wha Kim Kyung Hee University, Seoul, Korea

CASE 1 M/ Colon and Rectum, Biopsy (x8) Sigmoid colon, LAR

Kyung Hee University, Seoul, Korea Colon, Sigmoid, Biopsy S x40 Adenocarcinoma, moderately differentiated

Kyung Hee University, Seoul, Korea Colon, Descending, Biopsy S x40 Hyperplastic polyp

Kyung Hee University, Seoul, Korea Colon, Sigmoid, Biopsy S x40 Hyperplastic polyp

Kyung Hee University, Seoul, Korea Rectum, Biopsy S x40 Hyperplastic polyp

Kyung Hee University, Seoul, Korea Sigmoid colon, LAR S

Kyung Hee University, Seoul, Korea Sigmoid colon, LAR S

Kyung Hee University, Seoul, Korea CASE 2 F/ Terminal ileum to Rectum, Bx (x4) Perianal skin, Biopsy Anus, Biopsy

Kyung Hee University, Seoul, Korea Terminal ileum, Biopsy S x40

Kyung Hee University, Seoul, Korea Terminal ileum, Biopsy S x200

Kyung Hee University, Seoul, Korea Terminal ileum, Biopsy S x200

Kyung Hee University, Seoul, Korea Terminal ileum, Biopsy S x200 Chronic granulomatous inflammation

Kyung Hee University, Seoul, Korea Ascending colon, Biopsy S x40 Chronic inflammation with lymphoid hyperplasia

Kyung Hee University, Seoul, Korea Transverse colon, Biopsy S x40

Kyung Hee University, Seoul, Korea Transverse colon, Biopsy S x200 Chronic granulomatous inflammation

Kyung Hee University, Seoul, Korea Rectum, Biopsy S x40 Chronic inflammation

Kyung Hee University, Seoul, Korea Perianal skin, Biopsy S Acute and chronic inflammation (Abscess)

Kyung Hee University, Seoul, Korea Anus, Biopsy S Fistular tract with acute and chronic inflammation

Kyung Hee University, Seoul, Korea CASE 3 M/ Rectum, Biopsy Rectum, Biopsy Rectum, TME

Kyung Hee University, Seoul, Korea Rectum, Biopsy S x40 Adenocarcinoma, moderately differentiated

Kyung Hee University, Seoul, Korea Rectum, Biopsy S x40 No tumor (Chronic inflammation) (History of rectal cancer s/p concurrent chemoradiation therapy)

Kyung Hee University, Seoul, Korea Rectum, Total mesorectal excision S

Kyung Hee University, Seoul, Korea Rectum, Total mesorectal excision S

Kyung Hee University, Seoul, Korea Rectum, Total mesorectal excision S

Kyung Hee University, Seoul, Korea Tumor Regression Grade by Dworak (Int J Colorect Dis 1997;12:19-23) Grade 0: no regression; Grade 1: dominant tumor mass with obvious fibrosis and/or vasculopathy; Grade 2: dominantly fibrotic changes with few tumor cells or groups (easy to find); Grade 3: very few (difficult to find microscopically) tumor cells in fibrotic tissue with or without mucous substance; Grade 4: no tumor cells, only fibrotic mass (total regression or response)

Kyung Hee University, Seoul, Korea Rectum, Total mesorectal excision S x40

Kyung Hee University, Seoul, Korea Rectum, Total mesorectal excision S x40

Kyung Hee University, Seoul, Korea Diagnosis Rectum, total mesorectal excision: Adenocarcinoma, moderately differentiated, rectum (post neoadjuvant treatment status) 1) Tumor size: 2.5 cm x 1.0 cm x 1.0 cm 2) Tumor gross type: Ulceroinfiltrative 3) Depth of invasion: Tumor invades subserosa (ypT3) 4) Margins of resection: No tumor (safety margin: proximal 9.5 cm, distal 3.0 cm) 5) Lymphatic invasion: Not identified 6) Vascular invasion: Not identified 7) Perineural invasion: Not identified 8) Regional lymph nodes: No metastasis in 13 regional lymph nodes (0/13, pN0) 9) Tumor budding: Insignificant (1-5/ x200) 10) Tumor regression grade: Minimal regression (1)

Kyung Hee University, Seoul, Korea CASE 4 F/ Rectum, Px Rectum, Bx Colorectum, Bx and Px (x3) Colorectum, Bx (x3) Rectum, Bx (x2)

Kyung Hee University, Seoul, Korea Rectum, 1 cm from anal verge, Polypectomy S X12.5

Kyung Hee University, Seoul, Korea Rectum, 1 cm from anal verge, Polypectomy S X40

Kyung Hee University, Seoul, Korea Rectum, 1 cm from anal verge, Polypectomy S X200

Kyung Hee University, Seoul, Korea Diagnosis Rectum, 1cm from anal verge, polypectomy: Adenocarcinoma in situ, well differentiated 1) Size: 1x0.8 cm 2) No invasion of lamina propria 3) Clear deep resection margin (safety margin: 0.2 cm) 4) Lymphovascular invasion: not identified

Kyung Hee University, Seoul, Korea Rectum, Biopsy S X40 Chronic inflammation

Kyung Hee University, Seoul, Korea Transverse colon, Polypectomy S X40 Tubular adenoma with low grade dysplasia

Kyung Hee University, Seoul, Korea Transverse colon, Biopsy S X40 Tubular adenoma with low grade dysplasia

Kyung Hee University, Seoul, Korea Rectum, just above the anal verge, Biopsy S X40 Chronic inflammation

Kyung Hee University, Seoul, Korea Colon, 15cm from anal verge, Biopsy S X40 Tubular adenoma with low grade dysplasia

Kyung Hee University, Seoul, Korea Colon, 12cm from anal verge, Biopsy S X40 Tubular adenoma with low grade dysplasia

Kyung Hee University, Seoul, Korea Rectum, anal verge, Biopsy S X40 Chronic inflammation

Kyung Hee University, Seoul, Korea Rectum, 12cm from anal verge, Biopsy S X40 Tubular adenoma with low grade dysplasia

Kyung Hee University, Seoul, Korea Rectum, 12cm from anal verge, colonoscopic biopsy S X40 Tubular adenoma with low grade dysplasia

Kyung Hee University, Seoul, Korea CASE 5 F/ Rectum, Biopsy

Kyung Hee University, Seoul, Korea Rectum, 20cm anal verge, Biopsy S X40 Chronic ulcer