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Difference between revisions of "Medullary colorectal carcinoma"
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{{ Infobox diagnosis | |||
| Name = {{PAGENAME}} | |||
| Image = Photomicrograph_of_colorectal_medullary_carcinoma_x20a.jpg | |||
| Width = | |||
| Caption = Micrograph of a medullary colorectal carcinoma. [[H&E stain]]. | |||
| Synonyms = | |||
| Micro = Sheet-like architecture of malignant cells with vesicular nuclei, prominent nucleoli, and abundant eosinophilic cytoplasm. Admixed inflammatory cells (lymphocytes and neutrophils) are common. | |||
| Subtypes = | |||
| LMDDx = Poorly differentiated adenocarcinoma, melanoma, poorly differentiated neuroendocrine tumours, high grade lymphoma | |||
| Stains = | |||
| IHC = May lose CK20 and CDX2. Frequent loss of MLH1/PMS2. SATB2 +ve, BRAF VE1 +ve, calretinin +ve | |||
| EM = | |||
| Molecular = | |||
| IF = | |||
| Gross = | |||
| Grossing = | |||
| Staging = | |||
| Site = Colorectum, most commonly right side of colon | |||
| Assdx = | |||
| Syndromes = | |||
| Clinicalhx = | |||
| Signs = | |||
| Symptoms = | |||
| Prevalence = 1-3% of all colorectal carcinomas | |||
| Bloodwork = | |||
| Rads = | |||
| Endoscopy = | |||
| Prognosis = Some papers suggest better prognosis than conventional adenocarcinoma | |||
| Other = | |||
| ClinDDx = | |||
| Tx = | |||
}} | |||
'''Medullary colorectal carcinoma''' is a rare type of [[colorectal carcinoma]]. Precise incidence difficult to determine as there no strict criteria for diagnosis, especially if the tumour also contains conventional adenocarcinoma. Cases may not be recognised and diagnosed as poorly differentiated adenocarcinona instead.<ref name=pmid33247957>{{cite journal |vauthors=Scott N, West NP, Cairns A, Rotimi O |title=Is medullary carcinoma of the colon underdiagnosed? An audit of poorly differentiated colorectal carcinomas in a large national health service teaching hospital |journal=Histopathology |volume=78 |issue=7 |pages=963–969 |date=June 2021 |pmid=33247957 |doi=10.1111/his.14310 |url=}}</ref> | '''Medullary colorectal carcinoma''' is a rare type of [[colorectal carcinoma]]. Precise incidence difficult to determine as there no strict criteria for diagnosis, especially if the tumour also contains conventional adenocarcinoma. Cases may not be recognised and diagnosed as poorly differentiated adenocarcinona instead.<ref name=pmid33247957>{{cite journal |vauthors=Scott N, West NP, Cairns A, Rotimi O |title=Is medullary carcinoma of the colon underdiagnosed? An audit of poorly differentiated colorectal carcinomas in a large national health service teaching hospital |journal=Histopathology |volume=78 |issue=7 |pages=963–969 |date=June 2021 |pmid=33247957 |doi=10.1111/his.14310 |url=}}</ref> | ||
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*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 |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 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 | **A series with 102 cases suggests a better prognosis when compared on the basis of other pathological characteristics.<ref name=pmid25572685/> | ||
==Gross== | ==Gross== | ||