Pseudocarcinomatous invasion of colonic polyps

Cheung, Dominic K.; Attiyeh, Fadi F.

doi:10.1007/bf02603429

Cited by 6 publications

(4 citation statements)

References 4 publications

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“…Pseudoinvasion in adenomatous colorectal polyps is a well-recognized phenomenon, which over the years has also been called colitis cystica profunda ex adenoma [6], epithelial misplacement [10], pseudocarcinoma and pseudocarcinomatous invasion [5]. It is relatively common, especially compared with the number of adenomatous polyps that show true invasion.…”

Section: Discussionmentioning

confidence: 98%

Stromelysin-3 expression in early (pT1) carcinomas and pseudoinvasive lesions of the colorectum

Mueller

Arras

et al. 1997

Virchows Archiv

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Pseudoinvasion in colorectal adenomas is often difficult to distinguish from invasive carcinoma. Previous studies have indicated that expression of stromelysin-3 (ST-3), one of the metalloproteinase family of enzymes, may be useful for the identification of early invasive carcinoma. The goal of our study was to detect ST-3 expression in colorectal adenomatous polyps to see if it could be helpful for the differential diagnosis of pseudoinvasion vs. true invasion. We studied 25 polypectomy specimens which were divided histologically into 2 groups; the first consisted of 15 adenomas with invasive carcinoma, 8 of these carcinomas were more diffusely infiltrative (pT1), and 7 tended to be expansively invasive. The second group was composed of 10 adenomas with pseudoinvasion. A 35S labelled cDNA probe was used for in situ hybridization (ISH) and a monoclonal antibody (5ST-4A9) for immunohistochemistry (IHC). The distribution of ST-3 expression as detected by IHC and ISH was identical. All diffusely infiltrative carcinoma cases showed ST-3 expression, but only focally in 2 cases with marked lymphocytic infiltration. None of the expansive carcinoma or pseudoinvasion cases showed ST-3 expression. ST-3 expression seems to be an indicator of invasion, but a negative reaction for ST-3 does not rule out an expansive invasive neoplasm or a diffusely infiltrative invasive tumour with a dense lymphocytic reaction.

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Section: Discussionmentioning

confidence: 98%

Stromelysin-3 expression in early (pT1) carcinomas and pseudoinvasive lesions of the colorectum

Mueller

Arras

et al. 1997

Virchows Archiv

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“…One of the problems is ‘true invasion or pseudoinvasion’ when the tumor tissue is observed below the muscularis mucosae in a colorectal polypoid tumor. The submucosal tumor nodule that is composed of tumor tissue similar to the intramucosal tumor, surrounded by a rim of lamina propria and lacking desmoplastic reaction in the interstitium, is generally considered to be pseudoinvasion 5–8 . Most cases with pseudoinvasion are large and pedunculated polyps, and are located in the sigmoid colon.…”

mentioning

confidence: 99%

Pseudoinvasion of the colorectal polypoid tumors: Serial section study of problematic cases

Tanizawa

Seki

Nakano³

et al. 2003

Pathology International

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Ten cases of endoscopically removed colorectal polypoid tumors exhibiting lobular growth patterns in the submucosa without prominent desmoplastic changes in the interstitium were investigated using serial sections, and four cases were confirmed to be pseudoinvasion. The growth pattern of these four cases (pseudoinvasive tumors) was morphologically compared with the other six tumors (microinvasive tumors) in which obviously infiltrating foci were seen in minimal ranges. In the pseudoinvasive tumors, intramucosal tumor tissue spread into the submucosa through the narrow gap of the muscularis mucosae and formed a lobulated nodule larger than the gap of the muscularis mucosae. This suggested that squeezing of the herniated tumor tissue by muscularis mucosae at the gap was crucial to forming a typical feature of pseudoinvasion. The maximum diameters of the gap of the muscularis mucosae (G) and the submucosal tumor nodule (N) were measured under a microscope and compared between both groups. The mean N/G ratio of the pseudoinvasive tumors (1.73 +/- 0.46) indicated a significantly higher value than that of the microinvasive tumors (1.04 +/- 0.06; P < 0.01). The N/G ratio could be one of the indices used to distinguish a pseudoinvasive tumor from a microinvasive tumor in colorectal polypoid tumors.

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“…[50][51][52][53][54][55][56][57][58] Pseudoinvasion is relatively common, reported in 3% to 10% of resected colorectal polyps. Pseudoinvasion describes a situation in which neoplastic glands of the adenoma are mispositioned, presumably by trauma, into or beneath the muscularis mucosae.…”

Section: Malignant Polyps Differential Diagnosismentioning

confidence: 99%

“…[50][51][52][53][54][55][56][57][58][59] Table 23-2 illustrates histologic features that can aid in this differential diagnosis. In this case, the distinction between mucinous adenocarcinoma and misplaced glands can be extremely difficult.…”

Section: Malignant Polyps Differential Diagnosismentioning

confidence: 99%