Morphological Study of the Colorectal Carcinoma Infiltrating into the Muscular Coat.

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Colorectal carcinomas infiltrating into the muscular coat (pm carcinomas) are thought to be of significance to both surgeons and pathologists who deal with advanced large-bowel cancer. The pm carcinomas represent an intermediate stage of cancer development between colorectal carcinomas extending into the submucosa and those involving the subserosa. An attempt was therefore made to investigate the pathology of advanced colorectal carcinomas including pm carcinomas, by classifying them into 2 types according to their cross-sectional morphology, 1) polypoid growth (PG) type which produces a projecting nodule or polypoid growth within the confines of mucosa and 2) non-polypoid growth (NPG) type showing no such gross feature. Pm carcinomas accounted for 6.1 % of all colorectal carcinomas in our series. Vascular invasion and lymph node metastasis were of more frequent occurrence in NPG type than PG type of pm carcinomas, while the mean intramucosal tumor diameter was 30.3 mm for NPG type carcinomas as against 34.2 mm for PG type tumors, thus there was a noted tendency for a smaller intramucosal lesion of the former type to become capable of and initiate invasion of deep layers and adjacent structures. Pm carcinomas of the large intestine, unlike carcinomas infiltrating into the serosa, occurred most frequently in the rectum and this was considered to be related to the unique anatomical feature of rectum, i. e. its muscular coat and also to the fact that fibrotic reaction in area of cancer infiltration is of more frequent occurrence in the rectum.

Morphological Study of the Colorectal Carcinoma Infiltrating into the Muscular Coat.

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