Hashimoto H, et al. - In this investigation, researchers evaluated the pathological features of intramucosal colorectal carcinomas (CRCs) with lymphovascular invasion and the possibility of lymph node metastasis as an indication for additional surgery. They analyzed several histological characteristics and compared their incidence among nine such cases, as well as 20 other cases of intramucosal CRCs without lymphovascular invasion to delineate the histological characteristics of intramucosal CRCs with lymphovascular invasion. None of the seven lymph node-dissected cases of lymphovascular invasion intramucosal CRCs showed metastasis of the lymph node. In intramucosal CRCs with lymphovascular invasion, high-grade tumor budding and the pattern of 'eosinophilic cytoplasm and round nuclei with inflammatory reaction' are morphological characteristics that differ from those of non-invasive CRC, synonymous with high-grade dysplasia. Additional studies using a larger number of cases by focusing on the aforementioned histological pattern are expected to clarify the potential of such cases for lymph node metastasis.