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Tumor budding in colorectal carcinoma time to take notice.pdf


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Tumor budding

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B Mitrovic et al

Figure 2 ‘Challenging scenarios’. (a) Peritumoral inflammatory cells, including histiocytes, can be difficult to differentiate from tumor
buds, and may sometimes obscure the underlying budding. (b) Immunohistochemistry for anti-cytokeratin may help to highlight tumor
buds in this setting. (c) Given that tumor budding may represent an epithelial–mesenchymal transformation, their separation from
stromal cells can also be challenging and (d) anti-cytokeratin stains may be very useful in identifying tumor buds. (e) Fragmentation of
neoplastic glandular structures (arrow) can sometimes give the impression of extensive tumor budding on H&E and on
immunohistochemistry with (f) anti-cytokeratin. In this example, the small fragments/individual tumor cells highlighted by anticytokeratin in the region of the fragmented gland (arrow between fragments) may be a consequence of fragmentation rather than true
budding. (Original magnification: a— 40; b— 40; c— 100; d— 100; e— 200; f— 200).

subset of colorectal carcinomas with invasive
fronts that displayed a strikingly different architecture compared with the central area of the tumor,

with well-developed glandular structures giving
way to isolated tumor cells and small cell groups,
as illustrated in Figure 1. At the ultrastructural level,
Modern Pathology (2012) 25, 1315–1325