| 特集名 | 大腸IIcの病理組織診断 --組織診断の違いはどこにあるのか? | |
|---|---|---|
| 題名 | 補助的検討による大腸IIcの組織診断 (1) 癌の高・低異型度分類からみた大腸IIcの組織診 | |
| 発刊年月 | 1998年 03月 | |
| 著者 | 味岡 洋一 | 新潟大学医学部第一病理 |
| 【 要旨 】 | 要旨はありません。 | |
| Theme | Histopathological Diagnosis IIc Type of Colorectal Cancer | |
|---|---|---|
| Title | Pathological diagnosis of colorectal IIc type neoplasms with a special reference to cytological grade of atypia of carcinoma | |
| Author | Yoichi Ajioka | 1st Department of Pathology, Niigata University School of Medicine |
| [ Summary ] | The discrepancy in pathological diagnosis of IIc type neoplasms among pathologists is caused by the difference in histological criteria for colorectalcarcinoma. The difference consists of two aspects: whether or not one regards macroscopic depression as an implication of a potentially malignant characteristic, and recognition of cytologically low grade carcinoma. We discussed in detail these two apects on the basis of our histological criteria for colorectal epithelial neoplasms, and stressed the importance of recognising cytological characteristics of low grade carcinoma. IIc type neoplasms would be over diagnosed as carcinoma regarding depression as a marker for malignancy. Histological diagnosis should be done independently from the gross appearance of the tumors. We demonstrated that these is no pathological evidence to consider IIc neoplasms as having different biological characteristics (with respect to p53 gene protein over expression, expression of MUC 1 and MUC 2 mucin core proteins and cell proliferation) from other types of tumors if the histological grade of atypia is identical. On the other hand, some of IIc type intramucosal carcinomas could be under diagnosed adenoma. They are frequently (66.7%) low grade carcinoma which is occasionally difficult to differentiate from adenoma (high grade atypia). And they consisted of a rather unifrom histology, without accompanying adenoma and/or without coexistence of different grade of atypia of carcinoma. Careful microscopic observation with full understanding of the cytological characteristics of low grade carcinoma is required for the diagnosis of IIc type intramucosal carcinomas. |
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