Microvasculature of human colorectal epithelial tumors. An electron microscopic study.

The ultrastructure of the microvasculature in human colorectal adenomas and carcinomas was studied, and compared with that of normal tissue. Blood vessels in adenomas were generally of normal structure, whereas carcinoma vessels displayed a variety of structural alterations. Endothelial proliferation was frequently observed in all the eleven carcinomas examined, which confirms the reports of new vessel formation in experimental malignant tumors. The presence of fenestrations in obviously abnormal endothelium was tentatively attributed to hypoxia, vascular regression or immaturity of the cells, in spite of the fact that normal capillaries in colonic mucosa are fenestrated. Some vessels showed multilayered basement membranes, various types of activated cells containing numerous lysosomal granules, and thickened perivascular tissue. These features may be a vascular response to repeated damage or a manifestation of vascular remodelling. Dilated thin-walled vessels, which were usually found at the periphery of carcinomas, were identified as venules. Small vessels located between the closely apposed carcinoma tubules were not obviously abnormal. They were nevertheless considered to be tumor-induced vessels which had undergone differentiation. The differences in vascular morphology between adenomas and carcinomas were considered to be due to their different growth patterns, growth rates and degrees of maturity.