Kikuchi level

Last revised by Assoc Prof Frank Gaillard on 18 Feb 2018

The Kikuchi level is a histopathological term used for describing the degree of infiltration of a sessile early invasive colorectal cancer1. Preoperative assessment of the level of invasion using this classification may decrease the incidence of unnecessary surgery for sessile polyps. 

Levels of invasion
  • 1: invasion of superficial third of submucosa
  • 2: invasion up to intermediate third of submucosa
  • 3: invasion extending to the inner surface of muscularis propria

History and etymology

Kikuchi Ryuichi et al studied 182 proven cases of early invasive colorectal carcinomas in which invasion was no deeper than submucosa of underlying colonic wall. Various factors were studied which included configuration, diameter, histological grade and lymphovascular invasion. 

See also

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Cases and figures

  • Figure 1: level 1
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  • Figure 2: level 2
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  • Figure 3: level 3
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