J.Jpn. Surg. Soc.. 83(3): 308-319, 1982

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Original article

OBSERVATIONS ON THE ORIGIN OF ADENOMATOUS EPITHELIUM OF THE COLON
－THREE-DIMENSIONAL ANALYSIS OF THE UNICRYPTAL ADENOMA IN FAMILIAL POLYPOSIS－

Surface ultrastructural study of the flat colonic mucosa of the familial polyposis coli, using scanning electron microscope provided new information about the morphological features of the colonic unicryptal adenoma. Cryptal openings of the unicryptal adenomas are 2-6 times greater in diameter (Solitary Big Crypt) than that of normal crypts, and were composed of uniform pentagonal cells with short blunt irregular microvilli.
Three-dimensional analysis of 26 unicryptal adenomas was performed in combination with scanning electron microscope and histological serial sectioning. Morphological features of unicryptal adenomas were divided in two groups; Inwardly budding type, 17 and normal epithelium replacing type, 9. Unicryptal adenomas of inwardly budding type were composed entirely of adenomatous epithelium and mostly have branchings in the lower 1/3 of the colonic mucosa. Unicryptal adenomas of the normal epithelium replacing type had normal epithelium in the lower 1/2 of the glands, forming remakable cytological front against the adenomatous epithelium of the upper 1/2 of the gland. Almost all of the branchings were observed in the middle 1/3 of the mucosa in these types.
It seems a minute adenomas coluld be formed by fusion of multiple unicryptal adenomas.

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