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Colonic medullary carcinoma

Michael G Drage, Mingkhwan Tippayawong, Agoston T Agoston, Yifan Zheng, Raphael Bueno, Jason L Hornick, Robert D Odze, Amitabh Srivastava
CONTEXT: - The clinicopathologic and prognostic significance of ARID1A mutation in esophageal adenocarcinoma (EAC) is unknown. OBJECTIVE: - To determine the morphological correlates and prognostic significance of ARID1A-deficient EAC. DESIGN: - One hundred twenty cases of primary EAC were evaluated for a predetermined set of histologic features and immunohistochemistry for ARID1A, p53, and MLH1 performed on EAC, as well as adjacent Barrett esophagus and Barrett esophagus-associated dysplasia, when feasible...
April 25, 2017: Archives of Pathology & Laboratory Medicine
Mahmoud L Soliman, Ashish Tiwari, Qing Zhao
High-grade colonic neuroendocrine carcinomas (NECs) are uncommon but extremely aggressive. Their co-existence with tubular adenoma (TA) has rarely been reported. We present a 68-year-old man who was found on routine colonoscopy to have multiple colorectal TAs and an ulcerated lesion in the ascending colon. Microscopically, a poorly-differentiated invasive carcinoma juxtaposed with a TA was identified. Differential diagnosis included a poorly-differentiated adenocarcinoma, medullary carcinoma, high-grade NEC and lymphoma...
February 14, 2017: World Journal of Gastroenterology: WJG
Shigeki Sekine, Reiko Ogawa, Shinya Saito, Mineko Ushiama, Dai Shida, Takeshi Nakajima, Hirokazu Taniguchi, Nobuyoshi Hiraoka, Teruhiko Yoshida, Kokichi Sugano
AIMS: Immunohistochemistry for mismatch repair (MMR) proteins is being increasingly used to examine MMR status in tumours. The aim of the present article was to report the case of a colon cancer patient with Lynch syndrome who showed unusual cytoplasmic MMR protein localization. METHODS AND RESULTS: Histologically, the colon cancer was diagnosed as medullary carcinoma associated with prominent tumour-infiltrating lymphocytes and a Crohn's-like reaction. Immunohistochemistry revealed cytoplasmic and nuclear expression of MSH2 in non-neoplastic cells, and exclusively cytoplasmic expression in tumour cells...
March 2017: Histopathology
Shingo Inaguma, Jerzy Lasota, Zengfeng Wang, Anna Felisiak-Golabek, Hiroshi Ikeda, Markku Miettinen
The CD274 (PD-L1)/PDCD1 (PD-1) pathway is crucial for the modulation of immune responses and self-tolerance. Aberrantly expressed CD274 allows tumor cells to evade host immune system and is considered to be a mechanism of adaptive immune resistance. Inhibition of the CD274/PDCD1 immune checkpoint offers a promising new therapeutic strategy. Although CD274-expressing tumor cells have been identified in different types of tumors including colorectal cancer, clinicopathologic profile of these CD274-positive tumors has not been extensively studied...
February 2017: Modern Pathology: An Official Journal of the United States and Canadian Academy of Pathology, Inc
Yongkun Sun, Wei Niu, Feng Du, Chunxia Du, Shuting Li, Jinwan Wang, Li Li, Fengqing Wang, Yu Hao, Chuan Li, Yihebali Chi
BACKGROUND: Anlotinib is a novel multi-target tyrosine kinase inhibitor that is designed to primarily inhibit VEGFR2/3, FGFR1-4, PDGFR α/β, c-Kit, and Ret. We aimed to evaluate the safety, pharmacokinetics, and antitumor activity of anlotinib in patients with advanced refractory solid tumors. METHODS: Anlotinib (5-16 mg) was orally administered in patients with solid tumor once a day on two schedules: (1) four consecutive weeks (4/0) or (2) 2-week on/1-week off (2/1)...
October 4, 2016: Journal of Hematology & Oncology
Stephanie M Wood, Anthony J Gill, Alexander S Brodsky, Shaolei Lu, Kenneth Friedman, Galina Karashchuk, Kara Lombardo, Dongfang Yang, Murray B Resnick
Fatty acid-binding protein 1 (FABP1) is an intracellular protein responsible for the transportation of long chain fatty acids. Aside from its functions in lipid metabolism and cellular differentiation, FABP1 also plays a role in inflammation through its interaction with peroxisome proliferator-activated receptors (PPARs). Previously, we compared expression of colonic epithelium genes in a subset of microsatellite instable (MSI) colorectal carcinomas (medullary carcinomas) to normal colonic mucosa and found that FABP1 expression was markedly decreased in the tumors...
January 2017: Modern Pathology: An Official Journal of the United States and Canadian Academy of Pathology, Inc
Lama Farchoukh, Shih-Fan Kuan, Beth Dudley, Randall Brand, Marina Nikiforova, Reetesh K Pai
Between 10% and 15% of colorectal carcinomas demonstrate sporadic DNA mismatch-repair protein deficiency as a result of MLH1 promoter methylation and are thought to arise from sessile serrated adenomas, termed the serrated neoplasia pathway. Although the presence of the BRAF V600E mutation is indicative of a sporadic cancer, up to 30% to 50% of colorectal carcinomas with MLH1 promoter hypermethylation will lack a BRAF mutation. We report the clinicopathologic and molecular features of MLH1-deficient colorectal carcinoma with wild-type BRAF and MLH1 promoter hypermethylation (referred to as MLH1-hypermethylated BRAF wild-type colorectal carcinoma, n=36) in comparison with MLH1-deficient BRAF-mutated colorectal carcinoma (n=113) and Lynch syndrome-associated colorectal carcinoma (n=36)...
October 2016: American Journal of Surgical Pathology
Jung-Soo Pyo, Jin Hee Sohn, Guhyun Kang
Medullary carcinoma (MC) is a very rare variant of colorectal carcinoma (CRC). Its clinicopathologic findings are not fully elucidated. The aim of this study was to investigate the clinicopathological characteristics of MC in the colorectum through a systematic review and meta-analysis. The meta-analysis examined the incidence, age, sex, site, mismatch repair deficiency (MMRd), MMR protein expression, ARID1A expression, BRAF(V600E) mutation, KRAS mutation, and survival rate of MC. The 21469 CRCs included 462 MCs in 16 eligible studies, representing an estimated incidence of MC of 0...
July 2016: Human Pathology
Kenneth Friedman, Alexander S Brodsky, Shaolei Lu, Stephanie Wood, Anthony J Gill, Kara Lombardo, Dongfang Yang, Murray B Resnick
Medullary carcinoma of the colon is a unique histologic subtype of microsatellite unstable colorectal carcinoma but little is known regarding its tumor-immunoregulatory microenvironment. The aims of this study were to characterize the immune environment of medullary carcinoma and compare it with other microsatellite unstable and microsatellite stable colorectal carcinomas. An initial gene expression microarray analysis of six cases of medullary carcinoma was used to detect potentially differentially expressed genes...
May 2016: Modern Pathology: An Official Journal of the United States and Canadian Academy of Pathology, Inc
Nathaniel Melling, Ronald Simon, Jakob R Izbicki, Luigi M Terracciano, Carsten Bokemeyer, Guido Sauter, Andreas H Marx
PURPOSE: To investigate the significance of mammalian target of rapamycin (mTOR) in colorectal cancers. mTOR has recently been suggested as a prognostic biomarker and therapeutic target in an array of human cancers. FINDINGS: phospho-mTOR (p-mTOR) expression was analyzed by immunohistochemistry (IHC) on a tissue microarray containing 1800 colorectal cancers (CRC). Clinical follow-up data were available from all cancer patients. Positive p-mTOR immunostaining was seen in 83...
2015: International Journal of Clinical and Experimental Pathology
Panagiotis Kasapidis, Elias Grivas, Virginia Papamichail, Panagiotis Alfaras
No abstract text is available yet for this article.
April 2015: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
Robert D Knox, Nathan Luey, Loretta Sioson, Andrew Kedziora, Adele Clarkson, Nicole Watson, Christopher W Toon, Carmen Cussigh, Stuart Pincott, Stephen Pillinger, Yasser Salama, Justin Evans, John Percy, Margaret Schnitzler, Alexander Engel, Anthony J Gill
AIM: Medullary carcinoma is a recently described subtype of mismatch repair deficient (MMRd) colorectal carcinoma (CRC) which, despite being poorly differentiated by traditional morphological criteria, has been reported to have a good prognosis. We investigated the pathological and clinical features of medullary CRC in an unselected cohort of CRCs undergoing surgical resection. METHODS: All CRCs resected within a single health district database from 1998 to 2012 were categorized prospectively and underwent retrospective review to identify 91 medullary CRCs, with 11 additional cases from 2013 to 2014...
September 2015: Annals of Surgical Oncology
Shilpa Jain, Ankur Jain, Neil Onizuka, Sarag A Boukhar
Medullary carcinoma is a recently recognized rare subtype of colorectal cancer resembling both poorly differentiated adenocarcinoma and neuroendocrine tumors. Medullary carcinoma most commonly presents in the proximal colon and can be differentiated from other right-sided malignant lesions by histology and immunochemical markers. We present here a rare case of an adult patient with rectal bleeding who was found to have an intussusception due to underlying medullary carcinoma of the splenic flexure. A 72-year-old woman presented to our GI clinic with rectal bleeding...
November 2014: Hawai'i Journal of Medicine & Public Health: a Journal of Asia Pacific Medicine & Public Health
So-Jung Yeo, Kyu-Jin Kim, Bo-Yeon Kim, Chan-Hee Jung, Seung-Won Lee, Jeong-Ja Kwak, Chul-Hee Kim, Sung-Koo Kang, Ji-Oh Mok
Metastasis to the primary thyroid carcinoma is extremely rare. We report here a case of colonic adenocarcinoma metastasis to medullary thyroid carcinoma in a 53-yr old man with a history of colon cancer. He showed a nodular lesion, suggesting malignancy in the thyroid gland, in a follow-up examination after colon cancer surgery. Fine needle aspiration biopsy (FNAB) of the thyroid gland showed tumor cell clusters, which was suspected to be medullary thyroid carcinoma (MTC). The patient underwent a total thyroidectomy...
October 2014: Journal of Korean Medical Science
Anne-Marie Kanstrup Fiehn, Morten Grauslund, Anders Glenthøj, Linea Cecilie Melchior, Ben Vainer, Gro Linno Willemoe
Medullary carcinoma of the colon is a rare variant of colorectal cancer claimed to have a more favorable prognosis than conventional adenocarcinomas. The histopathologic appearance may be difficult to distinguish from poorly differentiated adenocarcinoma. The study aimed to evaluate the diagnostic interobserver agreement and to characterize the immunohistochemical and molecular differences between these two subgroups. Fifteen cases initially classified as medullary carcinoma and 30 cases of poorly differentiated adenocarcinomas were included...
January 2015: Virchows Archiv: An International Journal of Pathology
Andrew Mitchell, Yves Bendavid
Medullary carcinoma is a rare type of colon cancer with characteristic clinical and molecular features. Notably, despite its high-grade histology, the prognosis is generally better than for colonic adenocarcinoma of the usual type. We present herein a singular case of medullary colon cancer in which all of numerous lymph node metastases in the surgical resection specimen were completely necrotic in the face of a wholly viable primary tumor. Possible mechanisms are discussed with emphasis on immune-mediated factors...
October 22, 2014: Diagnostic Pathology
Christophe Rosty, Elizabeth J Williamson, Mark Clendenning, Rhiannon J Walters, Aung K Win, Mark A Jenkins, John L Hopper, Ingrid M Winship, Melissa C Southey, Graham G Giles, Dallas R English, Daniel D Buchanan
Adenocarcinomas of the colon and rectum are graded using a 2-tiered system into histologic low-grade and high-grade tumors based on the proportion of gland formation. The current grading system does not apply to subtypes of carcinomas associated with a high frequency of microsatellite instability (MSI), such as mucinous and medullary carcinomas. We investigated the combined effect of histologic grade and MSI status on survival for 738 patients with colorectal carcinoma (48% female; mean age at diagnosis 68...
October 2014: Human Pathology
Julia Cunningham, Kanchan Kantekure, Muhammad Wasif Saif
BACKGROUND: Most colon cancers are adenocarcinoma of the colon, which present with a typical histological type. However, a relatively newly-recognized subtype, called medullary carcinoma of the colon, has been characterized. This type is generally divided into subtypes of poorly-differentiated and undifferentiated medullary carcinoma. Only a handful of studies have been conducted thus far, mostly focusing on immunohistochemical and clinical characteristics of the disease. PATIENTS AND METHODS: Herein we present two cases seen at our hospital within one academic year...
May 2014: In Vivo
Shinichi Ban, Hiroyuki Mitomi, Hisashi Horiguchi, Hideaki Sato, Michio Shimizu
We reviewed the clinicopathological findings of eight cases of sessile serrated adenoma/polyps (SSA/Ps) with carcinoma, the largest diameter of which was 10 mm or less. All lesions were polyps located in the right side of the colon. Four lesions showed submucosal invasion and one lesion invaded the proper muscle layer. The depth of invasion, however, did not seem to be related to the carcinoma area size. Most carcinomas were well to moderately differentiated tubular adenocarcinomas focally showing some serrated appearances, and the predominant component of one carcinoma was a poorly differentiated medullary growth with inflammatory stroma...
March 2014: Pathology International
Johnny Nguyen, Domenico Coppola, Yuan Shan, Ling Zhang
Medullary carcinoma (MC) of the colon and rectum is a rare entity, accounting for less than 0.1% of colonic adenocarcinoma that poses a diagnostic challenge for the practicing pathologist. Poorly differentiated or undifferentiated MC with an unusual histological appearance and immunoprofile in addition to heavy lymphoid infiltrate could make it problematic when differentiating it from a high grade lymphoma, in particular anaplastic large B- or T-cell lymphoma, plasmablastic lymphoma, and other undifferentiated neoplasms...
2014: International Journal of Clinical and Experimental Pathology
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