Mucinous carcinoma: Difference between revisions

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'''Mucinous carcinoma''', also '''mucinous adenocarcinoma''', is an epithelial neoplasm that produces [[mucin]]. Mucinous carcinoma can arise in a number of sites.
[[Image:Colonic mucinous adenocarcinoma - low mag.jpg|thumb|right|Colonic mucinous adenocarcinoma. [[H&E stain]].]]
[[Image:Mucinous adenocarcinoma of prostate - 2b -- high mag.jpg|thumb|right|[[Mucinous adenocarcinoma of the prostate]] is a rare type of [[prostate cancer]]. [[H&E stain]].]]
[[Image:Mucinous lung adenocarcinoma and airway -- high mag.jpg|right|thumb|Mucinous [[adenocarcinoma of the lung]] is often cytologically bland as can be seen in this image; on the right is benign ciliated epithelium and on the left is mucinous adenocarcinoma. [[H&E stain]].]]
'''Mucinous carcinoma''', also '''mucinous adenocarcinoma''', is an epithelial neoplasm that produces [[mucin]]. Mucinous carcinoma can arise in a number of sites. It is also known as '''colloid carcinoma'''.<ref>URL: [http://www.merriam-webster.com/dictionary/colloid%20carcinoma http://www.merriam-webster.com/dictionary/colloid%20carcinoma]. Accessed on: 14 February 2014.</ref>


==General==
==General==
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*[[Mucinous breast carcinoma|Breast mucinous carcinoma]] has a better prognosis.
*[[Mucinous breast carcinoma|Breast mucinous carcinoma]] has a better prognosis.
*Colorectal mucinous carcinoma has a worse prognosis.<ref name=pmid22476818>{{Cite journal  | last1 = Hyngstrom | first1 = JR. | last2 = Hu | first2 = CY. | last3 = Xing | first3 = Y. | last4 = You | first4 = YN. | last5 = Feig | first5 = BW. | last6 = Skibber | first6 = JM. | last7 = Rodriguez-Bigas | first7 = MA. | last8 = Cormier | first8 = JN. | last9 = Chang | first9 = GJ. | title = Clinicopathology and Outcomes for Mucinous and Signet Ring Colorectal Adenocarcinoma: Analysis from the National Cancer Data Base. | journal = Ann Surg Oncol | volume =  | issue =  | pages =  | month = Apr | year = 2012 | doi = 10.1245/s10434-012-2321-7 | PMID = 22476818 }}</ref>
*Colorectal mucinous carcinoma has a worse prognosis.<ref name=pmid22476818>{{Cite journal  | last1 = Hyngstrom | first1 = JR. | last2 = Hu | first2 = CY. | last3 = Xing | first3 = Y. | last4 = You | first4 = YN. | last5 = Feig | first5 = BW. | last6 = Skibber | first6 = JM. | last7 = Rodriguez-Bigas | first7 = MA. | last8 = Cormier | first8 = JN. | last9 = Chang | first9 = GJ. | title = Clinicopathology and Outcomes for Mucinous and Signet Ring Colorectal Adenocarcinoma: Analysis from the National Cancer Data Base. | journal = Ann Surg Oncol | volume =  | issue =  | pages =  | month = Apr | year = 2012 | doi = 10.1245/s10434-012-2321-7 | PMID = 22476818 }}</ref>
*May be non-significant in esophagus if adjusted for grade and stage.<ref name=pmid23317610>{{Cite journal  | last1 = Zheng | first1 = DJ. | last2 = Cooke | first2 = DT. | title = A survival comparison of mucin-producing adenocarcinoma of the esophagus to conventional adenocarcinoma after esophagectomy. | journal = Am Surg | volume = 79 | issue = 1 | pages = 49-53 | month = Jan | year = 2013 | doi =  | PMID = 23317610 }}</ref>


===Specific sites===
===Specific sites===
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*[[Mucinous prostate carcinoma]].
*[[Mucinous prostate carcinoma]].
*[[Mucinous breast carcinoma]].
*[[Mucinous breast carcinoma]].
*[[Mucinous adenocarcinoma of the lung]].


==Gross==
==Gross==
*
*Gelatinous-like material.
**May have a consistency similar to ''Jello''.


Image:
===Images===
*[http://www.flickr.com/photos/pulmonary_pathology/3931951819/ Mucinous adenocarcinoma of the lung (flickr.com)].
*[http://www.flickr.com/photos/pulmonary_pathology/3931951819/ Mucinous adenocarcinoma of the lung (flickr.com)].
*[http://www.flickr.com/photos/euthman/482649679/ Ovarian mucinous cystadenocarcinoma (flickr.com/euthman)].


==Microscopic==
==Microscopic==
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*Adenoma with [[pseudoinvasion]] (pseudocarcinoma).<ref name=Ref_Odze512>{{Ref Odze|512}}</ref>
*Adenoma with [[pseudoinvasion]] (pseudocarcinoma).<ref name=Ref_Odze512>{{Ref Odze|512}}</ref>
*[[Adenocarcinoma]] with mucinous features - see ''proportion of mucin'' section.
*[[Adenocarcinoma]] with mucinous features - see ''proportion of mucin'' section.
 
*Other [[myxoid tumours]] - has an exhaustive long DDx.
Images:
*[http://commons.wikimedia.org/wiki/File:Colonic_mucinous_adenocarcinoma_-_low_mag.jpg Colonic mucinous adenocarcinoma - low mag. (WC)].
*[http://www.flickr.com/photos/pulmonary_pathology/3931951819/ Mucinous tumours of the ovary - several images (flickr.com)].


===Proportion of mucin===
===Proportion of mucin===
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*[[Mucinous colorectal carcinoma]]: > 50% of the tumour.<ref name=pmid17679024 >{{cite journal |author=Tozawa E, Ajioka Y, Watanabe H, ''et al.'' |title=Mucin expression, p53 overexpression, and peritumoral lymphocytic infiltration of advanced colorectal carcinoma with mucus component: is mucinous carcinoma a distinct histological entity? |journal=Pathol. Res. Pract. |volume=203 |issue=8 |pages=567–74 |year=2007 |pmid=17679024 |doi=10.1016/j.prp.2007.04.013 |url=}}</ref>
*[[Mucinous colorectal carcinoma]]: > 50% of the tumour.<ref name=pmid17679024 >{{cite journal |author=Tozawa E, Ajioka Y, Watanabe H, ''et al.'' |title=Mucin expression, p53 overexpression, and peritumoral lymphocytic infiltration of advanced colorectal carcinoma with mucus component: is mucinous carcinoma a distinct histological entity? |journal=Pathol. Res. Pract. |volume=203 |issue=8 |pages=567–74 |year=2007 |pmid=17679024 |doi=10.1016/j.prp.2007.04.013 |url=}}</ref>
*[[Mucinous gastric carcinoma]]: > 50% of the tumour.
*[[Mucinous gastric carcinoma]]: > 50% of the tumour.
*Mucinous (noncystic) carcinoma of the [[pancreas]]: > 80% of the tumour.<ref name=pmid11145249>{{Cite journal  | last1 = Adsay | first1 = NV. | last2 = Pierson | first2 = C. | last3 = Sarkar | first3 = F. | last4 = Abrams | first4 = J. | last5 = Weaver | first5 = D. | last6 = Conlon | first6 = KC. | last7 = Brennan | first7 = MF. | last8 = Klimstra | first8 = DS. | title = Colloid (mucinous noncystic) carcinoma of the pancreas. | journal = Am J Surg Pathol | volume = 25 | issue = 1 | pages = 26-42 | month = Jan | year = 2001 | doi =  | PMID = 11145249 }}</ref>
*[[Mucinous breast carcinoma]]: > 90% of the tumour.<ref name=pmid22006768>{{Cite journal  | last1 = Dogan | first1 = E. | last2 = Aksoy | first2 = S. | last3 = Dizdar | first3 = O. | last4 = Arslan | first4 = C. | last5 = Dede | first5 = DS. | last6 = Ozisik | first6 = Y. | last7 = Altundag | first7 = K. | title = Pure mucinous carcinoma of the breast: a single center experience. | journal = J BUON | volume = 16 | issue = 3 | pages = 565-7 | month =  | year =  | doi =  | PMID = 22006768 }}</ref>
*[[Mucinous breast carcinoma]]: > 90% of the tumour.<ref name=pmid22006768>{{Cite journal  | last1 = Dogan | first1 = E. | last2 = Aksoy | first2 = S. | last3 = Dizdar | first3 = O. | last4 = Arslan | first4 = C. | last5 = Dede | first5 = DS. | last6 = Ozisik | first6 = Y. | last7 = Altundag | first7 = K. | title = Pure mucinous carcinoma of the breast: a single center experience. | journal = J BUON | volume = 16 | issue = 3 | pages = 565-7 | month =  | year =  | doi =  | PMID = 22006768 }}</ref>
**One source suggests: > 50% of the tumour.<ref name=pmid20191033>{{cite journal |author=Park S, Koo J, Kim JH, Yang WI, Park BW, Lee KS |title=Clinicopathological characteristics of mucinous carcinoma of the breast in Korea: comparison with invasive ductal carcinoma-not otherwise specified |journal=J. Korean Med. Sci. |volume=25 |issue=3 |pages=361–8 |year=2010 |month=March |pmid=20191033 |pmc=2826751 |doi=10.3346/jkms.2010.25.3.361 |url=}}</ref>
**One source suggests: > 50% of the tumour.<ref name=pmid20191033>{{cite journal |author=Park S, Koo J, Kim JH, Yang WI, Park BW, Lee KS |title=Clinicopathological characteristics of mucinous carcinoma of the breast in Korea: comparison with invasive ductal carcinoma-not otherwise specified |journal=J. Korean Med. Sci. |volume=25 |issue=3 |pages=361–8 |year=2010 |month=March |pmid=20191033 |pmc=2826751 |doi=10.3346/jkms.2010.25.3.361 |url=}}</ref>
====Images====
=====Case=====
<gallery>
Image:Colonic_mucinous_adenocarcinoma_-_very_low_mag.jpg | [[Colorectal adenocarcinoma|Colonic mucinous adenocarcinoma]] - very low mag. (WC/Nephron)
Image:Colonic_mucinous_adenocarcinoma_-_low_mag.jpg | Colonic mucinous adenocarcinoma - low mag. (WC/Nephron)
</gallery>
=====Case=====
<gallery>
Image: Mucinous lung adenocarcinoma -- very low mag.jpg | Mucinous [[lung adenocarcinoma]] (MLA) - very low mag.
Image: Mucinous lung adenocarcinoma -- low mag.jpg | MLA - low mag.
Image: Mucinous lung adenocarcinoma -- intermed mag.jpg | MLA - intermed. mag.
Image: Mucinous lung adenocarcinoma - alt -- intermed mag.jpg | MLA - intermed. mag.
Image: Mucinous lung adenocarcinoma -- high mag.jpg | MLA - high mag.
Image: Mucinous lung adenocarcinoma -- very high mag.jpg | MLA - very high mag.
Image: Mucinous lung adenocarcinoma and airway -- intermed mag.jpg | MLA - intermed. mag.
Image: Mucinous lung adenocarcinoma and airway -- high mag.jpg | MLA - high mag.
Image: Mucinous lung adenocarcinoma and airway - alt -- high mag.jpg | MLA - high mag.
</gallery>
=====www=====
*[http://www.flickr.com/photos/pulmonary_pathology/3931951819/ Mucinous tumours of the ovary - several images (flickr.com)].
==Molecular==
*''May'' be associated with a [[KRAS mutation]].
==IHC==
IHC can be used to suggest a primary site for a mucinous adenocarcinoma:<ref name=pmid21881489>{{Cite journal  | last1 = Chu | first1 = PG. | last2 = Chung | first2 = L. | last3 = Weiss | first3 = LM. | last4 = Lau | first4 = SK. | title = Determining the site of origin of mucinous adenocarcinoma: an immunohistochemical study of 175 cases. | journal = Am J Surg Pathol | volume = 35 | issue = 12 | pages = 1830-6 | month = Dec | year = 2011 | doi = 10.1097/PAS.0b013e3182299c25 | PMID = 21881489 }}</ref>
*Upper GI tract: CK7 +ve (38/41 cases), CDX2 -ve (4 +ve/41 cases).
*Lower GI tract: CDX2 +ve (42/42 cases), CK20 +ve (41/42 cases), CK7 -ve (8 +ve/42 cases) positive cases usu. in rectum/anus, beta-catenin (nuclear) +ve (27/42 cases).
*Breast: CK7 +ve (18/18 cases), ER +ve (16/18 cases).
*Lung: CK7 +ve (16/16 cases).
*Gynecologic: CK7 +ve (25/27 cases).
A panel:
*CK7, CK20, beta-catenin, CDX2.
==Sign out==
In biopsies:
*''Adenocarcinoma with a mucinous component'' is probably the most objective way to sign out a case, if the primary site is not firmly established and a non-mucinous component is present.
<pre>
OMENTUM, CORE BIOPSY:
- METASTATIC MUCINOUS ADENOCARCINOMA, SEE COMMENT.
COMMENT:
The tumour cells stain as follows:
POSITIVE: CK20, CDX2.
NEGATIVE: CK7.
The immunostains are suggestive of a lower gastrointestinal tract primary. Radiologic
and endoscopic correlation is suggested.
</pre>


==See also==
==See also==
*[[Renal mucinous tubular and spindle cell carcinoma]].
*[[Renal mucinous tubular and spindle cell carcinoma]].
*[[Myxoid tumours]].


==References==
==References==
Retrieved from "https://librepathology.org/wiki/Mucinous_carcinoma"