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Villous Adenoma

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The villous processes are lined by columnar epithelium with low-grade dysplasia. There is hypercellularity and nuclear overcrowding. The nuclei are slightly enlarged, elongated, and hyperchromatic but are still uniform and maintain their polarity. Nucleoli are not prominent. There is some loss of goblet cell mucin. Mitotic activity is not significantly increased. Architecturally, the glands show crowding and branching. There is lack of maturation as the epithelial cells move from crypts to the surface. The cytologic features impart a basophilic appearance to the adenomatous epithelium on routine H&E staining. Note the contrast with normal colonic mucosa on the right.

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