Criteria of Loy and Kaplan for Villous Adenocarcinoma of the Colon

 

Histologic features:

(1) a high percent of the tumor showing a villous architecture

(2) presence of epithelial islands in a desmoplastic stroma (EIDS)

(3) nuclear atypia

(4) absence of papillary structures, psammoma bodies and hyaline globules (features of a colonic papillary adenocarcinoma)

Percent of Tumor Showing a Villous Architecture	Villous Score
none	0
1 to 25%	1
26 to 50%	2
51 to 75%	3
76 to 100%	4

 

A villous adenocarcinoma was defined as an adenocarcinoma with > 50% villous architecture (villous scores 3 or 4).

 

The villous islands may be surrounded by mucin and/or mucinous debris.

 

EIDS are seen in adenocarcinomas and not adenomas. A true EIDS shows epithelial islands surrounded by fibrous and collagenous stroma. Pseudo-EIDS occurs if isolated glands are surrounded by smooth muscle.

 

A villous adenocarcinoma tends to have a better prognosis because it is often diagnosed at a lower stage, without lymph node or distant metastases.