Difference between revisions of "Medullary colorectal carcinoma"

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==General==
==General==
*Rare subtype of colorectal carcinoma.
*Rare subtype of colorectal carcinoma.
*Typically has [[MSI|Microsatellite instability]].<ref name=pmid24815832 >{{cite journal |vauthors=Cunningham J, Kantekure K, Saif MW |title=Medullary carcinoma of the colon: a case series and review of the literature |journal=In Vivo |volume=28 |issue=3 |pages=311–4 |date=2014 |pmid=24815832 |doi= |url=}}</ref>
*Typically has [[MSI|Microsatellite instability]].<ref name=pmid24815832 >{{cite journal |authors=Cunningham J, Kantekure K, Saif MW |title=Medullary carcinoma of the colon: a case series and review of the literature |journal=In Vivo |volume=28 |issue=3 |pages=311–4 |date=2014 |pmid=24815832 |doi= |url=}}</ref>
*Prognostic significance dependent on study.
*Prognostic significance dependent on study.
**A small series suggests the prognosis of medullary carcinoma with MSI is worse that conventional colorectal carcinoma without MSI.<ref>{{cite journal |vauthors=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 |title=Medullary colonic carcinoma with microsatellite instability has lower survival compared with conventional colonic adenocarcinoma with microsatellite instability |journal=Prz Gastroenterol |volume=12 |issue=3 |pages=208–214 |date=2017 |pmid=29123583 |pmc=5672702 |doi=10.5114/pg.2016.64740 |url=}}</ref>
**A small series suggests the prognosis of medullary carcinoma with MSI is worse that conventional colorectal carcinoma without MSI.<ref>{{cite journal |authors=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 |title=Medullary colonic carcinoma with microsatellite instability has lower survival compared with conventional colonic adenocarcinoma with microsatellite instability |journal=Prz Gastroenterol |volume=12 |issue=3 |pages=208–214 |date=2017 |pmid=29123583 |pmc=5672702 |doi=10.5114/pg.2016.64740 |url=}}</ref>
**A series with 102 cases suggests a better prognosis when compared on the basis of other pathological characteristics.<ref name=pmid25572685>{{cite journal |vauthors=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 |title=Medullary colorectal carcinoma revisited: a clinical and pathological study of 102 cases |journal=Ann. Surg. Oncol. |volume=22 |issue=9 |pages=2988–96 |date=September 2015 |pmid=25572685 |doi=10.1245/s10434-014-4355-5 |url=}}</ref>
**A series with 102 cases suggests a better prognosis when compared on the basis of other pathological characteristics.<ref name=pmid25572685>{{cite journal |authors=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 |title=Medullary colorectal carcinoma revisited: a clinical and pathological study of 102 cases |journal=Ann. Surg. Oncol. |volume=22 |issue=9 |pages=2988–96 |date=September 2015 |pmid=25572685 |doi=10.1245/s10434-014-4355-5 |url=}}</ref>


==Gross==
==Gross==
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*Beta-catenin +ve.
*Beta-catenin +ve.
*MLH1 loss of staining.
*MLH1 loss of staining.
*Calretinin (67%-73%)<ref>{{cite journal |vauthors=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 |vauthors=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:
Note:

Revision as of 20:24, 24 May 2020

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%)[4][5]

Note:

  • CDX2, beta-catenin, MLH1 useful for differentiating from poorly differentiated colorectal carcinoma.

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. 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/.
  5. 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.