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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