Template:Colorectal adenocarcinoma - microscopy criteria

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Microscopy criteria for colorectal adenocarcinoma

  • Lesion is at least a "high grade intramucosal neoplasia" (high grade dysplasia) have:
  • Severe cytologic atypia[1]
  • Cribriform architecture, consisting of juxtaposed gland lumens without stroma in between, with loss of cell polarity. Rarely, they have foci of squamous differentiation (morules).[1]
  • 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.[1]
  • Invasive adenocarcinoma commonly displays:[1]
  • Varying degrees of gland formation with tall columnar cells
  • Frequent desmoplasia
  • Dirty necrosis, consisting of extensive central necrosis with granular eosinophilic karyorrhectic debris. Garland of cribriform glands are frequently found in their vicinity.
  • 1.0 1.1 1.2 1.3 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