Difference between revisions of "Neuroendocrine tumour of the appendix"

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*Classically subepithelial/mural.  
*Classically subepithelial/mural.  
*Various growth patterns:
*Various growth patterns:
**Nested (insular)
**Nested (insular).
**Trabecular
**Trabecular.
**Palisading  
**Palisading.
**Ribbons, rosettes
**Ribbons, [[rosette]]s.
*Fibrous stroma in between cell groups.
*Fibrous stroma in between cell groups.
*Cytomorphology
*Cytomorphology:
**Monotonous appearance with scanty mitoses.
**Monotonous appearance with scanty mitoses.
**Round central nuclei
**Round central nuclei.
**Stippled chromatin [[AKA]] salt-and-pepper chromatin, coarse chromatin.
**Stippled chromatin ([[AKA]] ''salt-and-pepper chromatin'' and ''coarse chromatin'').
**Eosinophilic granular cytoplasm
**Eosinophilic granular cytoplasm.
 
DDx:
*[[Colorectal adenocarcinoma]].
*Adenocarcinoid.
*[[Crypt cell carcinoma]], also known as ''goblet cell carcinoid''.
*[[Metastasis|Metastatic]] [[adenocarcinoma]].
*Normal ganglion cells in the Meissner plexus (submucosa) and Auerbach plexus (located between the inner and outer layers of the muscularis propria).


===Special Types===
===Special Types===
*Tubular carcinoid  
*Tubular carcinoid.
**Neuroendocrine cells forming tubules (no cell nests)
**Neuroendocrine cells forming tubules (no cell nests).
**Some tubules can contain mucin  
**Some tubules can contain mucin.
**Can be confused with adenocarcinoma  
**Can be confused with adenocarcinoma.
**Features suggesting tubular carcinoid (over adenocarcinoma):
**Features suggesting tubular carcinoid (over adenocarcinoma):
***Arises from base of crypts, with no disruption of surface epithelium.
***Arises from base of crypts, with no disruption of surface epithelium.
***No associated epithelial precursor (no adenomatous change).
***No associated epithelial precursor (no adenomatous change).
***Neuroendocrine cytologic features, without prominent atypia  
***Neuroendocrine cytologic features, without prominent atypia.
***IHC (NE markers +ve)  
***IHC (NE markers +ve).
 
*Goblet cell carcinoid - dealt with in the article ''[[crypt cell carcinoma]]''.
*Goblet cell carcinoid aka [[Crypt cell carcinoma]]
*Signet-ring cells forming glandular structures.
*Signet-ring cells forming glandular structures,
*Possibly also with extra-cellular mucin.{{fact}}
*Possibly also with extra-cellular mucin  
 
DDx:
*[[Colorectal adenocarcinoma]].
*Adenocarcinoid.
*[[Crypt cell carcinoma]] (goblet cell carcinoid).
*Metastatic adenocarcinoma.
*Normal ganglion cells in the Meissner plexus (submucosa) and Auerbach plexus (located between the inner and outer layers of the muscularis propria).  


===Images===
===Images===
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*Chromogranin A -ve/+ve.
*Chromogranin A -ve/+ve.
*Synaptophysin +ve.
*Synaptophysin +ve.
*Keratin positive, but CK7/CK20 negative  
*Keratin positive, but CK7/CK20 negative.{{fact}}
*S100 positive for appendix  
*S100 positive for appendix.{{fact}}
 
See: ''''.


==See also==
==See also==
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