Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Oct;38(10):100811.
doi: 10.1016/j.modpat.2025.100811. Epub 2025 Jun 11.

Clinicopathologic Features of Untreated Colorectal Cancer with Acellular Mucin-Only Lymph Nodes

Wenyi Luo  1 , Shaomin Hu  2 , Irene Rana Riahi  3 , Hanlin L Wang  3 , Nuha Shaker  4 , Ibrahim Abukhiran  4 , Tiffany Wang  5 , Alexandros D Polydorides  5 , Adeyinka Akinsanya  6 , Iván A González  6 , Catherine Hagen  7 , Rondell P Graham  7 , Mikhail Lisovsky  8 , Teri A Longacre  9 , Bindu Challa  10 , Wei Chen  10 , Daniel Harter  11 , Cameron Beech  11 , Mehran Najibi  12 , Wenqing Cao  12 , Michael Lee  13 , Stephen M Lagana  13 , Xiaoyan Liao  14 , Namrata Setia  15 , Lindsey M Westbrook  16 , Vishal S Chandan  17 , Won-Tak Choi  18 , Xianzhong Ding  19 , Raul S Gonzalez  20 , Purva Gopal  21 , Hwajeong Lee  22 , Pooja Navale  23 , Xiuli Liu  24 , Nicole C Panarelli  25 , Zhaohai Yang  26 , Michael G Drage  27 , Zhiqian Song  28 , Fangyong Li  28 , Iris D Nagtegaal  29 , Xuchen Zhang  30
Affiliations
Free article

Clinicopathologic Features of Untreated Colorectal Cancer with Acellular Mucin-Only Lymph Nodes

Wenyi Luo et al. Mod Pathol. 2025 Oct.
Free article

Abstract

Lymph nodes (LNs) containing only acellular mucin are considered negative for metastasis in treated colorectal cancers (CRCs). However, no data exist on how to stage these LNs in untreated CRCs. We collected 63 untreated CRC cases with LNs containing only acellular mucin from 27 US institutions and 23 additional cases from the Dutch Nationwide Pathology Databank. The practice patterns of pathologists in handling such cases, as well as the clinicopathological features of these cases, were analyzed. The survival of the study group was compared with 2 control groups: 102 pN0 and 76 pN1 untreated CRC cases. US and Dutch pathologists demonstrated similar practice patterns in assigning the pN stage and in the use of additional studies. Tumors in the study group were more likely to be located in the right colon, exhibit mucinous features, and be mismatch repair deficient compared with tumors in the pN0 and pN1 control groups. Compared with the pN1 control group, the study group showed significantly lower frequencies of lymphovascular invasion, local recurrence, and distant metastasis. No patient in the study group died of CRC, similar to the pN0 group. In contrast, the pN1 group had a significantly higher risk of CRC-related death. These findings suggest that LNs containing only acellular mucin in untreated CRCs should be interpreted as negative and staged as pN0, in line with current practice in neoadjuvant-treated CRCs.

Keywords: acellular mucin; colorectal cancer; lymph node; pathology; staging.

PubMed Disclaimer