Low grade tubuloglandular adenocarcinoma

Topic Completed: 29 January 2021

Minor changes: 8 June 2021

Copyright: 2002-2021,, Inc.

PubMed Search: Tubuloglandular adenocarcinoma [title]

Raul S. Gonzalez, M.D.
Page views in 2020: 758
Page views in 2021 to date: 923
Cite this page: Gonzalez RS. Low grade tubuloglandular adenocarcinoma. website. Accessed October 28th, 2021.
Definition / general
Essential features
  • Arises in patients with ulcerative colitis or Crohn's disease
  • Low grade histology may be difficult to distinguish from benign glands
  • Can arise directly from low grade dysplasia
  • ~10% of inflammatory bowel disease associated colon carcinomas are low grade tubuloglandular subtype
Clinical features
  • Median age 41.5 years
  • More common in ulcerative colitis than Crohn's disease
  • Patients may have synchronous conventional colorectal adenocarcinoma (see IBD associated carcinoma)
Prognostic factors
  • Patients generally do well unless a synchronous conventional colorectal carcinoma is also present
Gross description
  • May not be identifiable grossly; may be only identified on random sections
Microscopic (histologic) description
  • Small or medium sized glands with round or tubular shape
  • Malignant glands are extremely well differentiated and might only be identifiable as malignant based on location deep within the bowel wall
  • Desmoplasia is rare or absent
  • Overlying mucosa may show only low grade dysplasia
  • Areas of conventional adenocarcinoma may be visible
Microscopic (histologic) images

Contributed by Raul S. Gonzalez, M.D.
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Low grade tubuloglandular adenocarcinoma in ulcerative colitis patient

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Background colitis

Positive stains
Negative stains
Molecular / cytogenetics description
Sample pathology report
  • Ascending colon, resection:
    • Low grade tubuloglandular adenocarcinoma (see synoptic report)
    • Background severely active chronic colitis, consistent with patient’s reported history of ulcerative colitis.
Board review style question #1

Low grade tubuloglandular adenocarcinoma of the colon arises in patients with what risk factor?

  1. Familial adenomatous polyposis
  2. Inflammatory bowel disease
  3. Lynch syndrome
  4. Prior personal history of colon cancer
Board review style answer #1
B. Inflammatory bowel disease

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