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Colonic adenomas are classified based on the most dysplastic focus present. Dysplasia is categorized into two groups: low-grade (which includes mild and moderate dysplasia) and high-grade (which includes severe dysplasia and carcinoma-in-situ).

Low-grade dysplasia: The nuclei are slightly enlarged, elongated, and hyperchromatic but are still uniform and maintain their polarity. There is nuclear overcrowding and pseudostratification. Nucleoli are not prominent. Mature goblet cells are reduced in number. Architecturally, the glands show crowding and branching.

Image courtesy of: @Patholwalker.

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