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Mucinous borderline tumour of the ovary (view source)
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'''Mucinous borderline tumour of the ovary''' is an [[ovarian tumour]] with a low malignant potential. | |||
It is also known as '''ovarian mucinous borderline tumour''' and '''ovarian mucinous tumour of low malignant potential'''.<ref name=pmid21464732>{{Cite journal | last1 = Khunamornpong | first1 = S. | last2 = Settakorn | first2 = J. | last3 = Sukpan | first3 = K. | last4 = Suprasert | first4 = P. | last5 = Siriaunkgul | first5 = S. | title = Mucinous tumor of low malignant potential (borderline or atypical proliferative tumor) of the ovary: a study of 171 cases with the assessment of intraepithelial carcinoma and microinvasion. | journal = Int J Gynecol Pathol | volume = 30 | issue = 3 | pages = 218-30 | month = May | year = 2011 | doi = 10.1097/PGP.0b013e3181fcf01a | PMID = 21464732 }}</ref> | |||
==General== | |||
*Requires extensive sampling - to avoid missing an adenocarcinoma. | |||
Note: | |||
*The WHO prefers ''borderline'' over ''low malignant potential'' as the descriptor for these tumours.<ref name=pmid16100867>{{Cite journal | last1 = Acs | first1 = G. | title = Serous and mucinous borderline (low malignant potential) tumors of the ovary. | journal = Am J Clin Pathol | volume = 123 Suppl | issue = | pages = S13-57 | month = Jun | year = 2005 | doi = | PMID = 16100867 }}</ref> | |||
===Classification=== | |||
Subdivided into:<ref name=pmid15371946>{{Cite journal | last1 = Rodriguez | first1 = IM. | last2 = Irving | first2 = JA. | last3 = Prat | first3 = J. | title = Endocervical-like mucinous borderline tumors of the ovary: a clinicopathologic analysis of 31 cases. | journal = Am J Surg Pathol | volume = 28 | issue = 10 | pages = 1311-8 | month = Oct | year = 2004 | doi = | PMID = 15371946 }}</ref> | |||
# Intestinal type mucinous borderline tumour of the ovary ~ 90% of cases. | |||
# Endocervical type mucinous borderline tumour of the ovary ~ 10% of cases.<ref name=Ref_GP419>{{Ref GP|419}}</ref> | |||
==Gross== | |||
''Intestinal type mucinous borderline tumour of the ovary'' and ''endocervical type mucinous borderline tumour of the ovary'': | |||
*Complex multiloculated mass with mucin. | |||
*Often large - may > 30 cm. | |||
==Microscopic== | |||
===Intestinal type mucinous borderline tumour of the ovary=== | |||
Features: | |||
*Mucinous differentiation: | |||
**Tall [[columnar cell]]s with apical mucin - usu. resembles gastric foveolar epithelium. | |||
*Layering of epithelial cells (stratification). | |||
**Must be <= 3 cells.<ref name=Ref_GP416>{{Ref GP|416}}</ref> | |||
*+/-Papillary infoldings. | |||
**Projections into the cystic space. | |||
*+/-Mild nuclear atypia. | |||
*+/-Mitoses (focally). | |||
Notes: | |||
#Resembles a [[villous adenoma]] of the [[colon]].<ref name=Ref_GP>{{Ref GP|416}}</ref> | |||
#Borderline component must be >= 10% of the tumour.<ref name=Ref_GP>{{Ref GP|416}}</ref> | |||
#*Lesions with <10% borderline component are known as ''[[mucinous cystadenoma of the ovary]] with focal proliferation'' or ''[[mucinous cystadenoma of the ovary]] with focal atypia''. | |||
DDx: | |||
*[[Mucinous adenocarcinoma of the ovary]]. | |||
*[[Mucinous cystadenoma of the ovary]]. | |||
*[[Mucinous cystadenoma of the ovary]] with focal proliferation. | |||
<!-- Images: --> | |||
===Endocervical type mucinous borderline tumour of the ovary=== | |||
Features:<ref name=Ref_GP420>{{Ref GP|420}}</ref> | |||
#Cells with mucinous differentiation resembling endocervical epithelium: | |||
#*Tall [[columnar cell]]s with grey apical mucin. | |||
#Cells with eosinophilic cytoplasm - known as "pink cells". | |||
#Ciliated cells. | |||
*Neutrophils associated with the epithelium/mucin - common.<ref>URL: [http://www.webpathology.com/image.asp?n=12&Case=526 http://www.webpathology.com/image.asp?n=12&Case=526]. Accessed on: 9 January 2013.</ref> | |||
<!-- Images: --> | |||
===Comparing intestinal versus endocervical=== | |||
{| class="wikitable sortable" | |||
! Feature | |||
! Intestinal | |||
! Endocervical | |||
|- | |||
| Primary mucin producing cell | |||
| clear - well-diff. component, eosinophilic (pink) | |||
| eosinophilic (pink), grey or clear | |||
|- | |||
| Size | |||
| tall columnar (height:width >3:1) "champagne flute" | |||
| stubby columnar (height:width <3:1) | |||
|- | |||
| Accompanying epithelial cells | |||
| +/-goblet cells | |||
| pink cells, ciliated cells | |||
|- | |||
| Other cells | |||
| none | |||
| neutrophils (intraepithelial) - common | |||
|- | |||
| Images | |||
| | |||
| | |||
|} | |||
==Molecular== | |||
*[[KRAS mutation]]s common ~ 73% of mucinous borderline tumours in one series.<ref name=pmid9118042>{{Cite journal | last1 = Cuatrecasas | first1 = M. | last2 = Villanueva | first2 = A. | last3 = Matias-Guiu | first3 = X. | last4 = Prat | first4 = J. | title = K-ras mutations in mucinous ovarian tumors: a clinicopathologic and molecular study of 95 cases. | journal = Cancer | volume = 79 | issue = 8 | pages = 1581-6 | month = Apr | year = 1997 | doi = | PMID = 9118042 }}</ref> | |||
==Sign out== | |||
<pre> | |||
OVARY AND CYST, LEFT, OOPHORECTOMY: | |||
- MUCINOUS BORDERLINE TUMOUR, INTESTINAL TYPE, ARISING FROM A MUCINOUS CYSTADENOMA (INTESTINAL TYPE). | |||
- OVARIAN PARENCHYMA. | |||
</pre> | |||
==See also== | |||
*[[Ovarian tumours]]. | |||
==References== | |||
{{Reflist|1}} | |||
[[Category:Gynecologic pathology]] | |||
[[Category:Diagnosis]] | [[Category:Diagnosis]] | ||