colon polyps, HG dysplasia v CIS v intramucosal Ca - Gastrointestinal pathology

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5/18/2010 9:31:09 AM

MSpalding
Posts: 1

Seventh ed AJCC staging manual uses term intramucosal carcinoma and CIS for colon polyps with what I feel we had been told should termed as High Grade dysplasia. Basically cribriform architecture, confluent growth and even infiltration confined to lamina propria (no breech of muscularis mucosa, or involvement of submucosa thus no lymphatics) was best classified as high grade dysplasia rather than the use of term "carcinoma". Is there a movement back toward CIS terminology?

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5/23/2010 5:00:42 PM

Johnny
Posts: 1

No, I don't think there is any movement to use the terms "Intramucosal carcinoma" or "CIS" for what we know and call "High-grade dysplasia." This terminology is not new to the 7th edition and is listed also in the 6th edition. It is confusing to a lot of pathologists who follow the AJCC manual for staging and see this terminology. The term "Intramucosal carcinoma" and "CIS" may be more appropriate for lesions with invasion through the basement membranes but limited to the mucosa whereas the term "High-grade dysplasia" may be more applicable with complex lesions without any invasion of the basement membrane. As long as the terms are communicated well with clinicians and used consistently for the same lesions it is OK to use either. You are not alone in this quandary.

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