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Colon tumor


Aberrant crypt foci (ACF) in colon

Reviewers: Shilpa Jain, M.D, New York University (see Reviewers page)
Revised: 20 September 2010, last major update September 2010
Copyright: (c) 2003-2010, PathologyOutlines.com, Inc.


● Earliest neoplastic lesion of colon
● May predict future adenoma or carcinoma (Am J Gastroenterol 2006;101:1362, Am J Gastroenterol 2005;100:1283)
Endoscopy: aberrent cryptic foci are stained darker than normal crypts with Methylene blue using high-magnification chromoendoscopy, which helps in obtaining a targeted biopsy

Prognostic features

● ACF are markers of increased colorectal cancer risk, particularly those with dysplastic features (J Surg Oncol 2008;98:207)


● Crypts are 2-3x larger and more dilated than normal crypts, may have a foci of dysplasia
● ACF can be subclassified as dysplastic, non-dysplastic or mixed type
● Dysplastic ACF resemble adenomas

Micro images


Aberrant crypt foci (H&E, methylene blue)

Molecular description

● Dysplastic ACF are present both in familial adenomatous polyposis (FAP), which is the result of a germline mutation of the APC gene; and in sporadic colorectal carcinomas, due to mutations of K-ras (Am J Pathol 2005;166:1069)

Additional references

Cancer Epidemiol Biomarkers Prev 1991;1:57, Chemoprevention, World J Gastroenterol 2003;9:2642, Anticancer Res 2006;26:107

End of Colon tumor > Polyps > Aberrant crypt foci (ACF) in colon

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