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<p class="ql-align-justify">Immunistaining done with appropriate positive and negative controls and revealed:</p><p class="ql-align-justify"><strong>MLH1</strong>: Intact, nuclear expression in >90% of tumor cells. </p><p><strong>PMS2: </strong>Intact, nuclear expression in >90% of tumor cells. </p><p><strong>MSH2: </strong>Intact, nuclear expression in >90% of tumor cells.</p><p class="ql-align-justify"><strong>MSH6:</strong> Intact, nuclear expression in >90% of tumor cells.</p>
<p class="ql-align-justify">Referred block for immunostaining of rectosigmoid mass diagnosed as Adenocarcinoma grade 2 (pathology number 3700-2026 on 9 June 2026).</p>
<p>One referred paraffin block.</p>
<p><strong><em><u>Immunohistochemistry of rectosigmoid mass:</u></em></strong></p><ul><li><strong>Mismatch Repair (MMR) Status: Proficient (pMMR). See Comment.</strong></li></ul><h6><strong>Comment:</strong></h6><h6 class="ql-align-justify">The identification of invasive adenocarcinoma in a pMMR (mismatch repair proficient) context suggests a tumor that likely developed through the traditional chromosomal instability pathway rather than the microsatellite instability (MSI) pathway. For the patient, this translates to a significantly lower likelihood of an underlying hereditary condition like Lynch syndrome, although a review of family history remains a standard clinical precaution.</h6><h6 class="ql-align-justify">From a treatment perspective, pMMR status is a key biomarker; it indicates that the tumor is likely to follow standard chemotherapy protocols, as these “stable” tumors typically do not derive the same high level of benefit from immunotherapy as their dMMR counterparts.</h6>
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