Any guesses? Site? Diagnosis?#SurgPath #GIpath #PathTwitter @Teclis82 @pezhouh @CArnold_GI @mhassanaimc @ac_pathgal @ALBoothMD @SwikrityUMD @D_KumarMD @Gagandeepk5MD 
Here are the gross pictures of the same case. The above section is from appendix. On the left there are sections of the appendix and on the right is small bowel.
This is a hamartomatous (Peutz-Jeghers type) polyp grown in an appendicial diverticulum. Here are microscopic pictures of the appendix showing loss of muscularis propria in the diverticulum.
And here are representative microscopic images of the small bowel polyps showing the arborizing smooth muscles. This patient also had ovarian mucinous adenocarcinoma. Peutz-Jeghers syndrome is associated with STK11/LKB1 mutation. Most of the polyps occur in small bowel.
