Abstract
<p style="margin-bottom: 0in;"><span style="font-family: TimesNewRomanPS-BoldMT, serif;"><span style="font-size: x-small;"><strong>Objective: </strong><span style="font-family: TimesNewRomanPSMT, serif;">To study the histological features of macroscopically normal mucosa in colorectal carcinoma specimens and attempt to correlate the severity of these changes and the distance of the mucosa from the tumour.</span></span></span> <p style="margin-bottom: 0in;"><span style="font-family: TimesNewRomanPS-BoldMT, serif;"><span style="font-size: x-small;"><strong>Method: </strong><span style="font-family: TimesNewRomanPSMT, serif;">Ninety three resection margins from 52 specimens were categorized according to the distance from the tumour, 0-1cm, 1.1-5cm and more than 5cm. The histological parameters assessed included, lymphoid aggregates, acute inflammation, chronic inflammation, crypt distortion and villous change. These were graded as absent, mild, moderate and severe. The presence of intraepithelial lymphocytes, cystically dilated ducts and epithelial erosions were recorded as absent or present. Results were analyzed using Pearson Chi- square test and Fischer-Exact statistics.</span></span></span> <p style="margin-bottom: 0in;"><span style="font-family: TimesNewRomanPS-BoldMT, serif;"><span style="font-size: x-small;"><strong>Results: </strong><span style="font-family: TimesNewRomanPSMT, serif;">The histological features found included, lymphoid aggregates in 40% acute inflammation </span></span></span><span style="font-family: TimesNewRomanPSMT, serif;"><span style="font-size: x-small;">in 15% chronic inflammation in 16% crypt distortion 17%, cystically dilated glands 21%, epithelial erosion 13% and villous change 32%. The presence of cystically dilated glands showed a significant correlation with the distance from the tumour.</span></span> <p style="margin-bottom: 0in;"><span style="font-size: x-small;"><span style="font-family: TimesNewRomanPS-BoldMT, serif;"><strong>Conclusion: </strong></span><span style="font-family: TimesNewRomanPSMT, serif;">Varied histopathological features were observed in the mucosa adjacent to the tumour, awareness of which can prevent misinterpretation and over diagnosis of these features.</span></span> <p style="margin-bottom: 0in;"><span style="font-size: x-small;"><span style="font-family: TimesNewRomanPSMT, serif;">DOI: <a href="http://dx.doi.org/10.4038/jdp.v7i1.5594">http://dx.doi.org/10.4038/jdp.v7i1.5594</a></span></span> <p style="margin-bottom: 0in;"><span style="font-size: x-small;"><span style="font-family: TimesNewRomanPSMT, serif;"> </span></span><span style="font-family: Times New Roman, serif;"><span style="font-size: x-small;">Journal of Diagnostic Pathology 2012 (7); 1: 33-41</span></span>
Highlights
The surgical margins are sampled irrespective of their distance from the tumour from all specimens resected for colorectal carinoma
Ninety three resection margins, of 52 resected specimens from patients with colorectal carcinoma, who had no history of inflammatory bowel disease, no familial adenomatous polyposis coli and had not undergone neo-adjuvant therapy prior to surgery were included in the study
The histological parameters assessed and their frequency of occurrence in each of the resection margins grouped according to the distance from the tumour along with the chi Histological study of macroscopically normal mucosa adjacent to tumour in colorectal square value (X ) and the p value are given in table 1
Summary
The surgical margins are sampled irrespective of their distance from the tumour from all specimens resected for colorectal carinoma. Depending on the extent of the colonic resection the mucosa may be adjacent or far from the carcinoma. Several studies have shown that there are characteristic changes in the proximal mucosa adjacent to the carcinoma (transitional zone) compared to the mucosa distal to the carcinoma. These include both morphological and histochemical changes in the mucosa (1,2). In addition several authors have conducted mucin histochemical studies and noted that a transition from sulfomucin to sialomucin occurs in the mucosa adjacent to the carcinoma and that these changes are related to neoplastic or preneoplastic changes (1). Others have suggested that these morphological and histochemical changes are secondary changes rather than preneoplastic (2). It is important for the Pathologists to be aware of these histological changes as some may mimic specific disease conditions such as inflammatory bowel disease leading to misinterpretation and management problems
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