Difference between revisions of "Omentum"

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The '''omentum''' is a much neglected structure.  It is often removed in the context of [[gynecologic pathology|gynecologic oncology]] procedure.
The '''omentum''' is a much neglected structure.  It is often removed in the context of [[gynecologic pathology|gynecologic oncology]] procedure.


==General==
==Normal omentum==
Radiology:
===Microscopic===
Features:
*Fibroadipose tissue covered by mesothelium.
 
===Sign out===
<pre>
OMENTUM, OMENTECOMY:
- FIBROADIPOSE TISSUE COVERED BY MESOTHELIUM -- CONSISTENT WITH OMENTUM.
- NEGATIVE FOR MALIGNANCY.
</pre>
 
==Radiology==
*"Omental cake" refers to a thickened omentum.
*"Omental cake" refers to a thickened omentum.
**The finding is non-specific - etiologies:
**The finding is non-specific - etiologies:
***Metastatic tumours: stomach, ovary and colon.  
***Metastatic tumours: stomach, ovary and colon.  
***Infection: [[tuberculous]] peritonitis.<ref name=pmid12432108>{{cite journal |author=Roche CJ, O'Keeffe DP, Lee WK, Duddalwar VA, Torreggiani WC, Curtis JM |title=Selections from the buffet of food signs in radiology |journal=Radiographics |volume=22 |issue=6 |pages=1369–84 |year=2002 |pmid=12432108 |doi= 10.1148/rg.226025521|url=http://radiographics.rsnajnls.org/cgi/pmidlookup?view=long&pmid=12432108}}</ref>
***Infection: [[tuberculous]] [[peritonitis]].<ref name=pmid12432108>{{cite journal |author=Roche CJ, O'Keeffe DP, Lee WK, Duddalwar VA, Torreggiani WC, Curtis JM |title=Selections from the buffet of food signs in radiology |journal=Radiographics |volume=22 |issue=6 |pages=1369–84 |year=2002 |pmid=12432108 |doi= 10.1148/rg.226025521|url=http://radiographics.rsnajnls.org/cgi/pmidlookup?view=long&pmid=12432108}}</ref>
 
Histology:
*Fibroadipose tissue.


==Grossing==
==Grossing==
*There is no widely accepted evidence-based standard; thus, the protocol differs from centre to centre.
*There is no widely accepted evidence-based standard; thus, the protocol differs from centre to centre.
**In the context of a gynecologic malignancy/suspected gynecologic malignancy:
**In the context of a gynecologic malignancy/suspected gynecologic malignancy:
***One centre I worked at puts through six (standard) blocks if there is no gross evidence of disease.
***It is reasonable to put through six (standard) blocks if there is no gross evidence of disease.
***One study suggests 3-5 blocks is enough if there is no macroscopic disease, and one block enough if there is macroscopic disease.<ref name=pmid17922596>{{Cite journal  | last1 = Usubütün | first1 = A. | last2 = Ozseker | first2 = HS. | last3 = Himmetoglu | first3 = C. | last4 = Balci | first4 = S. | last5 = Ayhan | first5 = A. | title = Omentectomy for gynecologic cancer: how much sampling is adequate for microscopic examination? | journal = Arch Pathol Lab Med | volume = 131 | issue = 10 | pages = 1578-81 | month = Oct | year = 2007 | doi = 10.1043/1543-2165(2007)131[1578:OFGCHM]2.0.CO;2 | PMID = 17922596 }}</ref>
***One study suggests 3-5 blocks is enough if there is no macroscopic disease, and one block enough if there is macroscopic disease.<ref name=pmid17922596>{{Cite journal  | last1 = Usubütün | first1 = A. | last2 = Ozseker | first2 = HS. | last3 = Himmetoglu | first3 = C. | last4 = Balci | first4 = S. | last5 = Ayhan | first5 = A. | title = Omentectomy for gynecologic cancer: how much sampling is adequate for microscopic examination? | journal = Arch Pathol Lab Med | volume = 131 | issue = 10 | pages = 1578-81 | month = Oct | year = 2007 | doi = 10.1043/1543-2165(2007)131[1578:OFGCHM]2.0.CO;2 | PMID = 17922596 }}</ref>


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*[[Endometriosis]].
*[[Endometriosis]].
*[[Endosalpingiosis]].
*[[Endosalpingiosis]].
*[[Hernia sac|Omental hernia]].


===Malignant===
===Malignant===
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==See also==
==See also==
*[[Gynecologic pathology]].
*[[Gynecologic pathology]].
*[[Peritoneum]].


==References==
==References==

Latest revision as of 02:52, 29 May 2015

The omentum is a much neglected structure. It is often removed in the context of gynecologic oncology procedure.

Normal omentum

Microscopic

Features:

  • Fibroadipose tissue covered by mesothelium.

Sign out

OMENTUM, OMENTECOMY: 
- FIBROADIPOSE TISSUE COVERED BY MESOTHELIUM -- CONSISTENT WITH OMENTUM. 
- NEGATIVE FOR MALIGNANCY.

Radiology

  • "Omental cake" refers to a thickened omentum.
    • The finding is non-specific - etiologies:

Grossing

  • There is no widely accepted evidence-based standard; thus, the protocol differs from centre to centre.
    • In the context of a gynecologic malignancy/suspected gynecologic malignancy:
      • It is reasonable to put through six (standard) blocks if there is no gross evidence of disease.
      • One study suggests 3-5 blocks is enough if there is no macroscopic disease, and one block enough if there is macroscopic disease.[2]

Pathology of the omentum

Benign

Mesothelial:

Other:

Malignant

Primary:

Metastatic:

See also

References

  1. ↑ Roche CJ, O'Keeffe DP, Lee WK, Duddalwar VA, Torreggiani WC, Curtis JM (2002). "Selections from the buffet of food signs in radiology". Radiographics 22 (6): 1369–84. doi:10.1148/rg.226025521. PMID 12432108. http://radiographics.rsnajnls.org/cgi/pmidlookup?view=long&pmid=12432108.
  2. ↑ Usubütün, A.; Ozseker, HS.; Himmetoglu, C.; Balci, S.; Ayhan, A. (Oct 2007). "Omentectomy for gynecologic cancer: how much sampling is adequate for microscopic examination?". Arch Pathol Lab Med 131 (10): 1578-81. doi:10.1043/1543-2165(2007)131[1578:OFGCHM]2.0.CO;2. PMID 17922596.
  3. ↑ Garbin, O.; Hummel, M.; Diana, M.; Wattiez, A.. "Solitary fibrous tumor of the great omentum.". J Minim Invasive Gynecol 18 (6): 694-5. doi:10.1016/j.jmig.2011.01.013. PMID 22024257.
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