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Histopathology of Early Mucosal Neoplasias: Morphologic Carcinogenesis in the GI Tract

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Early Neoplasias of the Gastrointestinal Tract

Abstract

Endoscopists must be familiar with the macroscopic and histologic type, potential of malignant conversion, and kinetics of local and metastatic spread of neoplasias. The morphogenesis of early cancer has been much investigated and revealed at least five different morphologic pathways of carcinogenesis in the colon, three different pathways in the stomach, and at least two in the oesophagus. These pathways exhibit distinct macroscopic precursor and early malignant lesions. Endoscopic resection R0 en bloc is curative in mucosal T1a and incipient T1b submucosal-differentiated carcinomas of the gastric, oesophageal, or colonic wall. Apart from histologic grading and lymphatic or venous vascular invasion, vertical submucosal extension of early cancer predicts the probability of established lymph node metastases. To define the vertical and lateral margins of tumour infiltration after en bloc resection, the specimen must be documented endoscopically and macroscopically and sent oriented and intact to the pathology laboratory to obtain a precise pathological statement for decision on further management and follow-up.

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Acknowledgments

The authors gratefully acknowledge Susanna Mueller, M.D., Department of Pathology, Ludwig-Maximilians-University Munich, Munich, Germany, and Manfred Stolte, M.D., Institut für Pathologie, Kulmbach, for proofreading the chapter and focussing on the formal differences in histopathologic criteria of cancer diagnosis used by Japanese and Western pathologists.

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Authors and Affiliations

  1. Institute of Pathology, Paracelsus Medical University, Muellner Hauptstrasse 48, Salzburg, 5020, Austria

    Daniel Neureiter

  2. Department of Internal Medicine I, Institute of Physiology and Pathophysiology, Paracelsus Medical University, Muellner Hauptstrasse 48, Salzburg, 5020, Austria

    Tobias Kiesslich

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  1. Daniel Neureiter
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Correspondence to Daniel Neureiter .

Editor information

Editors and Affiliations

  1. Department of Internal Medicine I, Paracelsus Medical University/Salzburger, Landeskliniken, Salzburg, Austria

    Frieder Berr

  2. Department of Endoscopy, Saku Central Hospital, Advanced Care Center, Saku, Nagano, Japan

    Tsuneo Oyama

  3. Department of Digestive Diseases, Hôpital Eduard Herriot, Lyon, France

    Thierry Ponchon

  4. Division of R&D for Minor Invasive Treatment, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan

    Naohisa Yahagi

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Neureiter, D., Kiesslich, T. (2014). Histopathology of Early Mucosal Neoplasias: Morphologic Carcinogenesis in the GI Tract. In: Berr, F., Oyama, T., Ponchon, T., Yahagi, N. (eds) Early Neoplasias of the Gastrointestinal Tract. Springer, Boston, MA. https://doi.org/10.1007/978-1-4614-8292-5_2

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  • DOI: https://doi.org/10.1007/978-1-4614-8292-5_2

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