{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T22:00:44Z","timestamp":1785276044347,"version":"3.55.0"},"reference-count":23,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Intramucosal carcinoma (IMC) of the colorectum is a rare and diagnostically challenging neoplasm frequently recognized in patients with Lynch syndrome (LS) recently. This study aimed to compare the clinicopathologic features and immunophenotypes of LS-associated mismatch repair\u2013deficient (MMR-D) colorectal IMCs with mismatch repair\u2013proficient (MMR-P) IMCs and sporadic MMR-D IMCs, as well as to examine APC pathway alterations in LS-associated MMR-D IMCs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Pathology archives from 2004 to 2024 were reviewed for colorectal IMC cases. Clinical, endoscopic, morphologic, immunohistochemical, and next-generation sequencing data were analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 31 IMC cases were identified, including 9 LS-associated MMR-D, 5 sporadic MMR-D, and 17 MMR-P. Patients with LS who had MMR-D IMCs were significantly younger (P\u2009=\u2009.013), had more prior malignancies (P\u2009=\u2009.003), and had shorter colonoscopy intervals (P\u2009=\u2009.011) compared with patients with MMR-P and sporadic MMR-D. The LS-associated MMR-D IMCs were larger, more often infiltrated normal mucosa, and exhibited medullary and mucinous features more frequently than other IMCs. While expressing CDX2 and SATB2, LS-related MMR-D tumors showed less CK20 positivity than sporadic MMR-D and MMR-P IMCs (P\u2009=\u2009.003). Among LS-associated MMR-D IMCs, 37.5% exhibited nuclear \u03b2-catenin immunoreactivity, regardless of the specific MMR gene affected.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>These findings suggest that LS-associated MMR-D IMCs have distinct clinicopathologic and immunophenotypic profiles compared with MMR-P and sporadic MMR-D IMCs, emphasizing the need for unique diagnostic and management strategies for these patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ajcp\/aqag090","type":"journal-article","created":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T11:56:34Z","timestamp":1783511794000},"source":"Crossref","is-referenced-by-count":0,"title":["Unique characteristics of Lynch syndrome\u2013associated mismatch repair\u2013deficient colorectal intramucosal 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