Macroscopic Classification and Histo-Pathologic Evaluation of Early Colorectal Cancer with Elevated Type / 대한소화기내시경학회지

BACKGROUNDS/AIMS: Early colorectal cancer is defined as carcinoma with invasion to mucosa or submucosa irrespective of involvement of lymph node. Gross morphology is divided into elevated and depressed type according to growth pattern. Until now, carcinomas with elevated type have been found more frequently than depressed type in Korea. It is necessary to classify the macroscopy of morphology and evaluate histo-pathologic findings of early colorectal cancers. METHODS: 33 patients (35 foci) with early colorectal cancers were analyzed, macroscopically and pathologically. Early colorectal carcinoma with mucosal invasion is 25 cases, and with submucosal invasion, 10. RESULTS: Macroscopic classification: Ip 12, Isp 6, Is 9, IIa 1, IIa IIc 4, Isp IIc 1, LST 2. Among them, Ip (34%) is most. Among cancers with mucosal invasion, Ip (36%) is common, and with submucosal invasion, Is (40%) is common. Most of early colorectal cancers with elevated type were accompanied with surrounding adenoma. It's ratio is 100% in early colorectal cancer with mucosal invasion, and 50% with submucosal invasion. CONCLUSIONS: Pedunculated type (Ip) is common in early colorectal cancer with elevated type. Surrounding adenoma was usually (85%) accompanied with those. It is suggested that early colorectal cancer with elevated type would be originated from adenoma.

The Comparison of Histo-pathologic Findings and Pit Patterns of Colorectal Tumors / 대한소화기내시경학회지

BACKGROUND AND AIMS: To investigate the morphological and histopathological associations between an individual pit seen on stereomicroscopy or magnifying colonoscopy and an individual crypt seen in histological sections of colorectal tumors. METHODS: Fifty two colorectal lesions were examined by colonoscopy. The mucosal pits of the lesions were observed using a magnifying colonoscopy with a zoom 1 to 100 magnification after administering indigo carmine spray. The pits of the excised specimens were observed by using a stereomicroscopy after 0.2% cresyl violet stain. The pit patterns were classified into six types: normal round pit (I); asteroid pit (II); small round pit (IIIs); large tubular pit (IIIL); gyrus-like pit (IV); and non-structural pattern or amorphysm (V). Histologic diagnoses were determined by H&E staining under light microscopy. RESULTS: The histologic findings according to the pit patterns were 1 chronic nonspecific inflammation and 1 submucosal tumor in 2 cases with type I pit pattern; 4 hyperplastic polyps in 4 cases with type II; 1 hyperplastic polyp, 16 adenomas with low-grade dysplasia, 3 adenomas with high-grade dysplasia, and 1 carcinoma in situ in 21 cases with type IIIL; 4 adenomas with low-grade dysplasia, 3 adenomas with high-grade dysplasia, and 4 carcinoma in situ in 11 cases with type IV; 1 adenoma with low-grade dysplasia in 1 case with type II IIIL; 3 adenomas with low-grade dysplasia, 4 adenomas with high-grade dysplasia, and 2 carcinoma in situ in 9 cases with type IIIL IV; 1 adenoma with high-grade dysplasia, 2 carcinoma in situ, and 1 adenocarcinoma in 4 cases with type IV V. In assessing the histologic findings according to pit pattern by stereomicroscopy, the overall diagnostic predictive value was 82.6% (43/52), and the diagnostic accuracy in differential diagnosis between nonneoplastic and neoplastic lesions was 98% (51/52). The ratio of agreement of the pit pattern between the magnifying colonoscopy and the stereomicroscopy was 68% (17/25). CONCLUSIONS: The results suggest that there was a close correlation between the pit patterns and the histologic findings of colorectal tumors, and that the observation of pit patterns of colorectal lesions provides a differential diagnosis between neoplastic and nonneoplastic lesions.