In this study, only findings of high-grade intraepithelial neoplasia (carcinoma in situ) and intramucosal carcinoma
of squamous cells were considered true positives for esophageal squamous cell carcinoma .
The investigators determined that 8 patients had Barrett's esophagus with no cancer or dysplasia, 27 had high-grade dysplasia, and 8 had intramucosal carcinoma
. Another five patients had advanced pathology: Three had superficial submucosal invasion, and two had intramucosal carcinoma
with lymphatic channel invasion.
Distinction between high-grade dysplasia (HGD) and intramucosal carcinoma (IMC).
Intramucosal carcinoma (IMC) at the gastroesophageal junction.
For patients with known SIM, periodic endoscopic surveillance is recommended to screen for high-grade dysplasia and intramucosal carcinoma. (39-44) Current guidelines for surveillance recommend 4quadrant biopsies at 1- to 2-cm increments along the axial length of the glandular mucosa of the distal esophagus; however, the efficacy of surveillance endoscopy is limited by sampling error.
Optical coherence tomography to identify intramucosal carcinoma and high-grade dysplasia in Barrett's esophagus.
(48) All of the features, other than the pagetoid pattern, overlap with features of intramucosal carcinoma. Identification of single Paget-like cells (intraepithelial glandular neoplastic cells) in a biopsy specimen is invariably associated with an underlying adenocarcinoma containing at least a focal, poorly differentiated component (Figure 10).
Intramucosal Carcinoma.--Intramucosal carcinoma (lamina propria invasion) is defined primarily by its architectural properties.
D: Carcinoma in an Adenomatous Polyp: Microscopic Tumor Extension and High-Risk Features.--Colorectal adenomas containing invasive adenocarcinoma that extends through the muscularis mucosae into the submucosa have been defined as "malignant polyps." (13) This term encompasses cases in which the entire polyp head is replaced by carcinoma and adenomas with focal malignancy, but the definition excludes adenomas with highgrade dysplasia (intraepithelial carcinoma) or intramucosal carcinoma (invasive carcinoma limited to the lamina propria or invading no deeper than the muscularis mucosae) because these polyps possess negligible biologic potential for metastasis (14) (see Tis in note M).
pTis.--For colorectal carcinomas, "carcinoma in situ" (pTis) as a staging term includes cancer cells confined within the glandular basement membrane (intraepithelial carcinoma, synonymous with high-grade dysplasia) or invasive into the mucosal lamina propria, up to but not through the muscularis mucosae (intramucosal carcinoma).
The definition of malignant polyps excludes adenomas containing in situ carcinoma (also known as intraepithelial carcinoma) and carcinoma either limited to the lamina propria of the polyp mucosa or invading no deeper than the muscularis mucosae (intramucosal carcinoma), because these polyps possess no biological potential for metastasis.
([dagger]) For colorectal carcinomas, carcinoma in situ (Tis) as a staging term includes cancer cells confined within the glandular basement membrane (intraepithelial carcinoma) or invasive into the mucosal lamina propria, up to but not through the muscularis mucosae (intramucosal carcinoma).