Micropapillary carcinoma

Colon tumor
Carcinoma
Micropapillary carcinoma

Author: Raul Gonzalez M.D. (see Authors page)

Revised: 3 January 2017, last major update May 2015

Copyright: (c) 2002-2017, PathologyOutlines.com, Inc.

PubMed Search: Micropapillary carcinoma [title] colon

Table of Contents

Cite this page: Micropapillary carcinoma. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/colontumormicropapillary.html. Accessed July 14th, 2017.

Definition / general

Uncommon subtype of colonic adenocarcinoma with distinctive behavior
Officially recognized in WHO classification

Epidemiology

Micropapillary features may be present in 9% (Hum Pathol 2006;37:809) to 19% (Mod Pathol 2007;20:729) of colorectal carcinomas

Pathophysiology

Lymph node metastasis are very common, even in pT1 / pT2 tumors (Am J Surg Pathol 2009;33:1287)
Prognosis worse than for conventional colorectal carcinoma (Colorectal Dis 2012;14:e567)

Case reports

72 year old woman with invasive micropapillary carcinoma of sigmoid colon (Int J Clin Exp Pathol 2008;1:457)

Microscopic (histologic) description

Small clusters of malignant cells with abundant eosinophilic cytoplasm and pleomorphic nuclei
Micropapillae inhabit lacunar-like spaces and demonstrate a "reverse polarity" configuration, with apical surfaces facing the periphery rather than the center
Lymphovascular invasion is commonly present
Morphology is similar to micropapillary carcinomas of other organs (Adv Anat Pathol 2004;11:297)
Coexisting regions of conventional adenocarcinoma also usually present

Microscopic (histologic) images

Images hosted on other servers:

Invasive micropapillae in lacunar-like spaces

Lymph node metastasis

Characteristic morphology and MUC1 immunostaining pattern

Positive stains

MUC1 ("inside out" staining pattern (Histopathology 2005;47:479)
SOX2, NOTCH3 (stem cell markers) (Mod Pathol 2013;26:1123)

Molecular / cytogenetics description

Increased rate of TP53 alterations and lower rate of microsatellite instability (Mod Pathol 2011;24:729)

Differential diagnosis

Tumor budding: does not show "reverse polarity" (Histopathology 2002;40:127)