Aberrant crypt foci

Topic Completed: 1 September 2010

Minor changes: 30 September 2020

Copyright: 2003-2021,, Inc.

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

Shilpa Jain, M.D.
Page views in 2020: 967
Page views in 2021 to date: 1,079
Cite this page: Jain S. Aberrant crypt foci. website. Accessed October 28th, 2021.
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)
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