A 60-Year-Old Man Is Found to Have a 5-Cm Exophytic

A 60-year-old man is found to have a 5-cm exophytic mass in the ascending colon during a screening colonoscopy.  Biopsy of the mass shows adenocarcinoma.  The patient has no personal or family history of malignancy or colonic polyps.  His medical problems include hypertension, and he does not use tobacco or alcohol.  CT scan of the chest and abdomen reveals no metastatic lesions in the lungs or liver.  A right colectomy is performed.  The presence of which of the following indicates a poor prognosis in this patient?

A) Abundant, well-formed glands in the tumor
B) Cytokeratin expression by the malignant cells
C) Malignant cells invading the lamina propria
D) Prominent lymphocyte infiltration of the tumor
E) Tumor cell deposits in the regional lymph nodes

Correct Answer:

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