Colon tumor
Aberrant crypt foci (ACF) in colon

Author: Shilpa Jain, M.D. (see Authors page)

Revised: 9 August 2018, last major update September 2010

Copyright: (c) 2003-2018,, Inc.

PubMed Search: Aberrant crypt foci [title] (ACF) colon

Cite this page: Jain, S. Aberrant crypt foci (ACF) in colon. website. Accessed December 11th, 2018.
Definition / general
  • 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
Prognosis and treatment
  • ACF are markers of increased colorectal cancer risk, particularly those with dysplastic features (J Surg Oncol 2008;98:207)
Microscopic (histologic) description
  • Crypts are 2 - 3x larger and more dilated than normal crypts, may have a foci of dysplasia
  • ACF can be subclassified as dysplastic, nondysplastic or mixed type
  • Dysplastic ACF resemble adenomas
Molecular / cytogenetics 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 KRAS (Am J Pathol 2005;166:1069)