{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T15:26:14Z","timestamp":1781969174341,"version":"3.54.5"},"reference-count":24,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2021,4,19]],"date-time":"2021-04-19T00:00:00Z","timestamp":1618790400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Histopathology"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:sec><jats:title>Aims<\/jats:title><jats:p>Medullary carcinoma is an uncommon colorectal tumour which appears poorly differentiated histologically. Consequently, it may be confused with poorly differentiated adenocarcinoma not otherwise specified (NOS). The principal aim of this study was to review a large series of poorly differentiated colorectal cancers resected at a large National Health Service (NHS) Teaching Hospital to determine how often medullary carcinomas were misclassified . Secondary aims were to investigate how often neuroendocrine differentiation or metastatic tumours were considered in the differential diagnosis, and compare clinico\u2010pathological features between medullary and poorly differentiated adenocarcinoma NOS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and results<\/jats:title><jats:p>Histology slides from 302 colorectal cancer resections originally reported as poorly differentiated adenocarcinoma were reviewed and cases fulfilling World Health Organisation (WHO) criteria for medullary carcinoma identified. The original pathology report was examined for any mention of medullary phenotype, consideration of neuroendocrine differentiation or consideration of metastasis from another site. Clinico\u2010pathological features were compared to poorly differentiated adenocarcinoma NOS.<\/jats:p><jats:p>Only one\u2010third of medullary carcinomas were correctly identified between 1997 and 2018. The other two\u2010thirds were reported as poorly differentiated adenocarcinoma NOS. The possibility of an extracolonic origin or neuroendocrine carcinoma was considered in 21 and 27% of reports. Most medullary carcinomas exhibited mismatch repair deficiency, were located in ascending colon and caecum and had a lower rate of vascular channel invasion and lymph node metastasis compared to poorly differentiated adenocarcinoma.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Medullary carcinoma of the colon is often mistaken for poorly differentiated adenocarcinoma NOS and occasionally for neuroendocrine or metastatic carcinoma. Greater familiarity with morphological criteria and use of mismatch repair protein staining should improve diagnosis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/his.14310","type":"journal-article","created":{"date-parts":[[2020,11,28]],"date-time":"2020-11-28T20:05:03Z","timestamp":1606593903000},"page":"963-969","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Is medullary carcinoma of the colon underdiagnosed? An audit of poorly differentiated colorectal carcinomas in a large national health service teaching hospital"],"prefix":"10.1111","volume":"78","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2132-793X","authenticated-orcid":false,"given":"Nigel","family":"Scott","sequence":"first","affiliation":[{"name":"Department of Histopathology Leeds Teaching Hospitals NHS Trust Leeds UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nick P","family":"West","sequence":"additional","affiliation":[{"name":"Pathology and Data Analytics Leeds Institute of Medical Research at St James University of Leeds Leeds UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alison","family":"Cairns","sequence":"additional","affiliation":[{"name":"Department of Histopathology Leeds Teaching Hospitals NHS Trust Leeds UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olorunda","family":"Rotimi","sequence":"additional","affiliation":[{"name":"Department of Histopathology Leeds Teaching Hospitals NHS Trust Leeds UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,4,19]]},"reference":[{"key":"e_1_2_7_2_1","volume-title":"WHO classification of tumours of the digestive system","author":"Bosman FT","year":"2010"},{"key":"e_1_2_7_3_1","unstructured":"2018 Royal College of Pathologists London UK MB Loughrey PQ Quirke NA Shepherd Dataset for histopathological reporting of colorectal cancer"},{"key":"e_1_2_7_4_1","unstructured":"BurgartLJ KakarS ShiCet al.Protocol for the examination of resection specimens from patients with primary carcinoma of the colon and rectum. 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