Difference between revisions of "Medullary colorectal carcinoma"

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DDx:
DDx:
*Other (poorly differentiated) [[colorectal carcinoma]]s.
*Other (poorly differentiated) [[colorectal carcinoma]]s.
**Colorectal cancer with loss of [[SMARCB1]] expression.<ref name=pmid32083567/>
*Carcinomas with neuroendocrine differentiation.
*Carcinomas with neuroendocrine differentiation.
*[[Lymphoepithelioma-like carcinoma]] of the colon.<ref>{{cite journal |authors=Delaney D, Chetty R |title=Lymphoepithelioma-like carcinoma of the colon |journal=Int J Clin Exp Pathol |volume=5 |issue=1 |pages=105–9 |date=2012 |pmid=22295155 |pmc=3267494 |doi= |url=}}</ref>
*[[Lymphoepithelioma-like carcinoma]] of the colon.<ref>{{cite journal |authors=Delaney D, Chetty R |title=Lymphoepithelioma-like carcinoma of the colon |journal=Int J Clin Exp Pathol |volume=5 |issue=1 |pages=105–9 |date=2012 |pmid=22295155 |pmc=3267494 |doi= |url=}}</ref>
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*Calretinin (67%-73%)<ref>{{cite journal |authors=Winn B, Tavares R, Fanion J, Noble L, Gao J, Sabo E, Resnick MB |title=Differentiating the undifferentiated: immunohistochemical profile of medullary carcinoma of the colon with an emphasis on intestinal differentiation |journal=Hum. Pathol. |volume=40 |issue=3 |pages=398–404 |date=March 2009 |pmid=18992917 |pmc=2657293 |doi=10.1016/j.humpath.2008.08.014 |url=}}</ref><ref>{{cite journal |authors=Lin F, Shi J, Zhu S, Chen Z, Li A, Chen T, Wang HL, Liu H |title=Cadherin-17 and SATB2 are sensitive and specific immunomarkers for medullary carcinoma of the large intestine |journal=Arch. Pathol. Lab. Med. |volume=138 |issue=8 |pages=1015–26 |date=August 2014 |pmid=24437456 |doi=10.5858/arpa.2013-0452-OA |url=}}</ref>
*Calretinin (67%-73%)<ref>{{cite journal |authors=Winn B, Tavares R, Fanion J, Noble L, Gao J, Sabo E, Resnick MB |title=Differentiating the undifferentiated: immunohistochemical profile of medullary carcinoma of the colon with an emphasis on intestinal differentiation |journal=Hum. Pathol. |volume=40 |issue=3 |pages=398–404 |date=March 2009 |pmid=18992917 |pmc=2657293 |doi=10.1016/j.humpath.2008.08.014 |url=}}</ref><ref>{{cite journal |authors=Lin F, Shi J, Zhu S, Chen Z, Li A, Chen T, Wang HL, Liu H |title=Cadherin-17 and SATB2 are sensitive and specific immunomarkers for medullary carcinoma of the large intestine |journal=Arch. Pathol. Lab. Med. |volume=138 |issue=8 |pages=1015–26 |date=August 2014 |pmid=24437456 |doi=10.5858/arpa.2013-0452-OA |url=}}</ref>


Note:
Notes:
*CDX2, beta-catenin, MLH1 useful for differentiating from poorly differentiated colorectal carcinoma.
*CDX2, beta-catenin, MLH1 useful for differentiating from poorly differentiated colorectal carcinoma.
*SMARCB1 loss - reported in one case.<ref name=pmid32083567>{{cite journal |authors=Melloul S, Mosnier JF, Masliah-Planchon J, Lepage C, Le Malicot K, Gornet JM, Edeline J, Dansette D, Texereau P, Delattre O, Laurent Puig P, Taieb J, Emile JF |title=Loss of SMARCB1 expression in colon carcinoma |journal=Cancer Biomark |volume=27 |issue=3 |pages=399–406 |date=2020 |pmid=32083567 |doi=10.3233/CBM-190287 |url=}}</ref>


==See also==
==See also==

Revision as of 17:10, 26 May 2023

Medullary colorectal carcinoma is a rare type of colorectal carcinoma.

General

  • Rare subtype of colorectal carcinoma.
  • Typically has microsatellite instability.[1]
  • Prognostic significance dependent on study.
    • A small series suggests the prognosis of medullary carcinoma with MSI is worse that conventional colorectal carcinoma without MSI.[2]
    • A series with 102 cases suggests a better prognosis when compared on the basis of other pathological characteristics.[3]

Gross

  • Well-circumscribed.

Microscopic

Features:

  • Poorly differentiated carcinoma:
    • Noninfiltrative border.
    • Solid pattern/nests.
    • No gland formation.
    • Lymphocytic infiltrate.

DDx:

IHC

Features:[1]

  • CDX2 +ve.
  • Beta-catenin +ve.
  • MLH1 loss of staining.
  • Calretinin (67%-73%)[6][7]

Notes:

  • CDX2, beta-catenin, MLH1 useful for differentiating from poorly differentiated colorectal carcinoma.
  • SMARCB1 loss - reported in one case.[4]

See also

References

  1. ↑ 1.0 1.1 Cunningham J, Kantekure K, Saif MW (2014). "Medullary carcinoma of the colon: a case series and review of the literature". In Vivo 28 (3): 311–4. PMID 24815832.
  2. ↑ Gómez-Álvarez MA, Lino-Silva LS, Salcedo-Hernández RA, Padilla-Rosciano A, Ruiz-García EB, López-Basave HN, Calderillo-Ruiz G, Aguilar-Romero JM, Domínguez-Rodríguez JA, Herrera-Gómez Á, Meneses-García A (2017). "Medullary colonic carcinoma with microsatellite instability has lower survival compared with conventional colonic adenocarcinoma with microsatellite instability". Prz Gastroenterol 12 (3): 208–214. doi:10.5114/pg.2016.64740. PMC 5672702. PMID 29123583. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5672702/.
  3. ↑ Knox RD, Luey N, Sioson L, Kedziora A, Clarkson A, Watson N, Toon CW, Cussigh C, Pincott S, Pillinger S, Salama Y, Evans J, Percy J, Schnitzler M, Engel A, Gill AJ (September 2015). "Medullary colorectal carcinoma revisited: a clinical and pathological study of 102 cases". Ann. Surg. Oncol. 22 (9): 2988–96. doi:10.1245/s10434-014-4355-5. PMID 25572685.
  4. ↑ 4.0 4.1 Melloul S, Mosnier JF, Masliah-Planchon J, Lepage C, Le Malicot K, Gornet JM, Edeline J, Dansette D, Texereau P, Delattre O, Laurent Puig P, Taieb J, Emile JF (2020). "Loss of SMARCB1 expression in colon carcinoma". Cancer Biomark 27 (3): 399–406. doi:10.3233/CBM-190287. PMID 32083567.
  5. ↑ Delaney D, Chetty R (2012). "Lymphoepithelioma-like carcinoma of the colon". Int J Clin Exp Pathol 5 (1): 105–9. PMC 3267494. PMID 22295155. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3267494/.
  6. ↑ Winn B, Tavares R, Fanion J, Noble L, Gao J, Sabo E, Resnick MB (March 2009). "Differentiating the undifferentiated: immunohistochemical profile of medullary carcinoma of the colon with an emphasis on intestinal differentiation". Hum. Pathol. 40 (3): 398–404. doi:10.1016/j.humpath.2008.08.014. PMC 2657293. PMID 18992917. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2657293/.
  7. ↑ Lin F, Shi J, Zhu S, Chen Z, Li A, Chen T, Wang HL, Liu H (August 2014). "Cadherin-17 and SATB2 are sensitive and specific immunomarkers for medullary carcinoma of the large intestine". Arch. Pathol. Lab. Med. 138 (8): 1015–26. doi:10.5858/arpa.2013-0452-OA. PMID 24437456.
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