Histological Variants of Colorectal Adenocarcinoma and Clinicomorphological Association
Naruemon Wisedopas MD*, Duangpen Thirabanjasak MD*, Narida Chirakalwasan MD*, Mana Taweevisit MD*
Affiliation : * Department of Pathology, Faculty of Medicine, Chulalongkorn University
Objective : Besides TNM staging system, some special histological features of colonic carcinomas are associ-
ated with variable clinicopathological parameters. The objective was to provide new information of correla-
tion between various histomorphological parameters together with available clinical data and each special
feature
Materials and Methods : A retrospective study of 162 materials collected from subjects with first diagnosed as
adenocarcinoma of colorectum in King Chulalongkorn Memorial Hospital over a period of 2 years from 2002
to 2003.
Result: One hundred and forty-seven cases of prominent cribiform feature are related to patient age (p =
0.025) and infiltrative margin (p = 0.006). Thirty-two cases with mucinous component are associated with
patient age (p = 0.009) and tumor depth (p = 0.015). Thirteen cases with signet ring cell morphology are
correlated with nodal and distant organ metastasis (p = 0.023 and p = 0.020, respectively) as well as
angiolymphatic invasion (p = 0.015). In addition the size of signet ring cell containing carcinomas is also
related to location (p = 0.036). It is larger in proximal site and smaller in distal counterpart. The authors did
not find any statistical significance in 9 cases of medullary carcinoma. Notably, our 33 cases showed biphasic
or triphasic feature.
Conclusion : Each distinct histological variant of colorectal adenocarcinoma is associated with some different
clinicopathological variables, mostly effecting clinical outcome. Pathologists should be concerned with
special histological subtypes of colorectal adeonocarcinomas and communicate with physicians for proper
management.
Keywords : Colorectal neoplasia, Cribiform, Mucinous, Signet ring cell, Medullary
