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Intramucosal colorectal carcinoma with lymphovascular invasion: clinicopathological characteristics of nine cases
Author(s) -
Hashimoto Hirotsugu,
Horiuchi Hajime,
Kurata Atsushi,
Kikuchi Hiroyuki,
Okuyama Rikiya,
Usui Genki,
Masuda Yoshio,
Kuroda Masahiko,
Inoue Shigeru,
Furushima Kaoru,
Matsuhashi Nobuyuki,
Harihara Yasushi,
Morikawa Teppei
Publication year - 2019
Publication title -
histopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.626
H-Index - 124
eISSN - 1365-2559
pISSN - 0309-0167
DOI - 10.1111/his.13826
Subject(s) - lymphovascular invasion , tumor budding , medicine , pathology , colorectal cancer , lymph node , pathological , lymphatic system , carcinoma , metastasis , lymph node metastasis , cancer
Aims Recent studies have provided the concept of invasive intramucosal colorectal carcinoma ( CRC ), and a case of intramucosal CRC with lymphatic invasion has been reported; however, the characteristics of such cases and the risk of lymph node metastasis have never been investigated. Therefore, we aimed to assess the pathological characteristics of intramucosal CRC s with lymphovascular invasion as well as the possibility of lymph node metastasis as an indication for additional surgery. Methods and results To delineate the histological features of intramucosal CRC s with lymphovascular invasion, we analysed several histological features and compared their incidence among nine such cases, as well as 20 other cases of intramucosal CRC s without lymphovascular invasion. High‐grade tumour budding and a pattern of ‘eosinophilic cytoplasm and round nuclei with inflammatory reaction ( ERI )’ were morphological characteristics of intramucosal CRC s with lymphovascular invasion, compared with those without lymphovascular invasion (both P < 0.05). Among the seven lymph node‐dissected cases of intramucosal CRC s with lymphovascular invasion, none showed lymph node metastasis. Conclusions In intramucosal CRC s with lymphovascular invasion, high‐grade tumour budding and the ‘ ERI ’ pattern are morphological characteristics that are distinct from those of non‐invasive CRC , which is synonymous with high‐grade dysplasia. Further studies using a larger number of cases by focusing on the above‐mentioned histological pattern are expected to clarify the potential of lymph node metastasis of such cases.