Systematic Review
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Jan 15, 2019; 11(1): 59-70
Published online Jan 15, 2019. doi: 10.4251/wjgo.v11.i1.59
Gut-associated lymphoid tissue or so-called “dome” carcinoma of the colon: Review
Aoife J McCarthy, Runjan Chetty
Aoife J McCarthy, Runjan Chetty, Department of Anatomical Pathology, Laboratory Medicine Program, University Health Network, Toronto, ON M5G 2C4, Canada
Aoife J McCarthy, Runjan Chetty, Department of Laboratory Medicine and Pathobiology, Faculty of Medicine, University of Toronto, Toronto, ON M5G 2C4, Canada
Author contributions: Both authors contributed to this paper.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Aoife J McCarthy, MB BCh BAO BMed Sci CHAT FRCPath, Doctor, Clinical Fellow, Department of Anatomical Pathology, Laboratory Medicine Program, University Health Network, 200 Elizabeth Street, 11th Floor, Eaton Wing, Toronto, ON M5G 2C4, Canada. aoife.mccarthy@uhn.ca
Telephone: +1-416-3405319 Fax: +1-416-3405517
Received: July 16, 2018
Peer-review started: July 17, 2018
First decision: August 8, 2018
Revised: September 13, 2018
Accepted: October 12, 2018
Article in press: October 12, 2018
Published online: January 15, 2019
Abstract
AIM

To present a comprehensive review of the etiology, clinical features, macroscopic and pathological findings, and clinical significance of Gut-associated lymphoid tissue or “dome” carcinoma of the colon.

METHODS

The English language medical literature on gut- or gastrointestinal-associated lymphoid tissue (GALT) or “dome” carcinoma of the colon was searched and appraised.

RESULTS

GALT/dome-type carcinomas of the colon are thought to arise from the M-cells of the lymphoglandular complex of the intestine. They are typically asymptomatic and have a characteristic endoscopic plaque- or “dome”-like appearance. Although the histology of GALT/dome-type carcinomas displays some variability, they are characterized by submucosal localization, a prominent lymphoid infiltrate with germinal center formation, tumor-infiltrating lymphocytes, absence of desmoplasia, and dilated glands lined by columnar epithelial cells with bland nuclear features and cytoplasmic eosinophilia. None of the patients reported in the literature with follow-up have developed metastatic disease or local recurrence.

CONCLUSION

Increased awareness amongst histopathologists of this variant of colorectal adenocarcinoma is likely to lead to the recognition of more cases.

Keywords: Dome-type carcinoma, Gastrointestinal-associated lymphoid tissue carcinoma, Gut-associated lymphoid tissue, Lymphoglandular complex, Colorectal cancer

Core tip: This review comprehensively presents the etiology, clinical features, macroscopic and pathological findings, and clinical significance of gut- or gastrointestinal-associated lymphoid tissue (GALT) or “dome” carcinoma of the colon. These lesions are thought to arise from the M-cells of the GALT (lymphoglandular complex) of the intestine. They have a characteristic endoscopic plaque- or “dome”-like appearance. Histologically, they are characterized by submucosal localization, a prominent lymphoid infiltrate with germinal center formation, and dilated glands lined by bland columnar epithelial cells with eosinophilic cytoplasm. There have been no reports of metastatic disease or local recurrence in patients with colonic GALT/dome-type carcinomas.