Template:Colorectal adenocarcinoma - microscopy criteria
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Microscopy criteria for colorectal adenocarcinoma
- A lesion at least "high grade intramucosal neoplasia" (high grade dysplasia) has:
- Severe cytologic atypia
- Cribriform architecture, consisting of juxtaposed gland lumens without stroma in between, with loss of cell polarity. Rarely, they have foci of squamous differentiation (morules).
- This should be distinguished from cases where piles of well-differentiated mucin-producing cells appear cribriform. In such piles, nuclei show regular polarity with apical mucin, and their nuclei are not markedly enlarged.
- Invasive adenocarcinoma commonly displays:
- Varying degrees of gland formation with tall columnar cells.
- Frequenty desmoplasia.
- Dirty necrosis, consisting of extensive central necrosis with granular eosinophilic karyorrhectic cell detritus. It is located within the glandular lumina, or often with a garland of cribriform glands in their vicinity.
It may also show lymphovascular invasion.
- Robert V Rouse. Adenocarcinoma of the Colon and Rectum. Stanford University School of Medicine. Original posting/updates: 1/31/10, 7/15/11, 11/12/11
- Li, Lianhuang; Jiang, Weizhong; Yang, Yinghong; Chen, Zhifen; Feng, Changyin; Li, Hongsheng; Guan, Guoxian; Chen, Jianxin (2014). "Identification of dirty necrosis in colorectal carcinoma based on multiphoton microscopy ". Journal of Biomedical Optics 19 (6): 066008. doi:10.1117/1.JBO.19.6.066008. ISSN 1083-3668.