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Table 4 Features helpful in distinguishing invasive adenocarcinoma from mucosal herniation (Boivin et al., 2003)

From: Apc-related models of intestinal neoplasia: a brief review for pathologists

Feature

Favors Invasive Carcinoma

Favors Herniated Epithelium

Comparison with overlying mucosa

Invasive cells are different from overlying mucosa, with changes exceeding low grade dysplasia

Dysplasia is absent

Desmoplasia

Present; not associated with prominent inflammatory infiltrate.

Absent; lamina propria may exhibit fibromuscular obliterative changes in prolapse

Crypt/gland profile

Irregular, pointed, angulated crypt profiles

Rounded; may be cystically dilated

Spread relative to mucosal surface

Invading crypts spread laterally

No lateral spread from overlying mucosa.

Cell loss from leading edge

Present; crypts are incompletely lined by epithelium

Absent; crypts are completely lined by epithelial cells

Number of crypts in question

More than 2 invading crypts

Two or fewer crypts in question

Basement membrane

Discontinuous

Continuous

Findings in other mice of the same genotype

Evidence of progression to invasive cancer in other mice

No invasive cancer in other mice