Difference between revisions of "Mucinous tumours of the appendix"

Jump to navigation Jump to search

Mucinous tumours of the appendix (view source)

Revision as of 22:10, 8 June 2015

2,498 bytes added ,  22:10, 8 June 2015
m
→‎General: fix typo
m (→‎General: fix typo)
 
(15 intermediate revisions by 3 users not shown)
Line 1: Line 1:
{{ Infobox diagnosis
| Name      = {{PAGENAME}}
| Image      = Mucinous cystadenoma of the appendix -- intermed mag.jpg
| Width      =
| Caption    = Mucinous cystadenoma of the [[appendix]]. [[H&E stain]].
| Synonyms  =
| Micro      = mucin, +/- nuclear atypia
| Subtypes  = see ''LMDDx''
| LMDDx      = [[mucinous adenocarcinoma]], entrapped mucin, mucinous cystadenoma
| Stains    =
| IHC        =
| EM        =
| Molecular  =
| IF        =
| Gross      =
| Grossing  =
| Site      = [[appendix]]
| Assdx      =
| Syndromes  =
| Clinicalhx =
| Signs      =
| Symptoms  =
| Prevalence = uncommon
| Bloodwork  =
| Rads      =
| Endoscopy  =
| Prognosis  = dependent on stage and presence/absence of nuclear atypia
| Other      =
| ClinDDx    = other appendiceal tumours, metastatic tumours
| Tx        = right hemicolectomy or appendectomy (?)
}}
{{ Infobox external links
{{ Infobox external links
| Name          = Mucinous tumours of the appendix
| Name          = Mucinous tumours of the appendix
Line 11: Line 42:
==General==
==General==
*There are many classifications and they are controversial.<ref name=pmid21970481>{{Cite journal  | last1 = Panarelli | first1 = NC. | last2 = Yantiss | first2 = RK. | title = Mucinous neoplasms of the appendix and peritoneum. | journal = Arch Pathol Lab Med | volume = 135 | issue = 10 | pages = 1261-8 | month = Oct | year = 2011 | doi = 10.5858/arpa.2011-0034-RA | PMID = 21970481 }}</ref>
*There are many classifications and they are controversial.<ref name=pmid21970481>{{Cite journal  | last1 = Panarelli | first1 = NC. | last2 = Yantiss | first2 = RK. | title = Mucinous neoplasms of the appendix and peritoneum. | journal = Arch Pathol Lab Med | volume = 135 | issue = 10 | pages = 1261-8 | month = Oct | year = 2011 | doi = 10.5858/arpa.2011-0034-RA | PMID = 21970481 }}</ref>
**The controversy centres on whether to call all mucinous tumours outside of the appendix ''adenocarcinoma'' - regardless of whether they have atypia & show invasion.
**The controversy centres on whether to call all mucinous tumours outside of the appendix ''adenocarcinoma'' - regardless of whether they have [[nuclear atypia|atypia]] & show invasion.
*''Panarelli and Yantiss'' created a nice summary table - that compare the classifications - see: [http://www.archivesofpathology.org/action/showFullPopup?id=i1543-2165-135-10-1261-t01&doi=10.5858%2Farpa.2011-0034-RA comparison of classifications (archivesofpathology.org)].<ref name=pmid21970481/>
*Many potential pathways for extra-appendiceal spread and peritoneal mucin deposition (pseudomyxoma peritonei)
**A mucinous neoplasm ruptures the appendix due to expansion by excessive mucin
***Could occur with either a benign or malignant neoplasm.
**Malignant mucinous glands infiltrate through the appendiceal wall or enter the lymphatics and spread throughout the peritoneum.
***Would require a malignant neoplasm.
*''Panarelli and Yantiss'' created a nice summary table - that compares the classifications - see: [http://www.archivesofpathology.org/action/showFullPopup?id=i1543-2165-135-10-1261-t01&doi=10.5858%2Farpa.2011-0034-RA comparison of classifications (archivesofpathology.org)].<ref name=pmid21970481/>
*In women - an ovarian primary must be excluded.
*In women - an ovarian primary must be excluded.
**Concurrent ''bilateral'' ovarian tumours suggests the tumour originated from the appendix and spread to the ovaries.
**Concurrent ''bilateral'' ovarian tumours suggests the tumour originated from the appendix and spread to the ovaries.
*[[Onlinepathology]] prefers the classification of Misdraji,<ref name=pmid12883241>{{cite journal |author=Misdraji J, Yantiss RK, Graeme-Cook FM, Balis UJ, Young RH |title=Appendiceal mucinous neoplasms: a clinicopathologic analysis of 107 cases |journal=Am. J. Surg. Pathol. |volume=27 |issue=8 |pages=1089–103 |year=2003 |month=August |pmid=12883241 |doi= |url=http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=0147-5185&volume=27&issue=8&spage=1089}}</ref> as it is the least complicated
*The 2003 classification by Misdraji ''et al.''<ref name=pmid12883241>{{cite journal |author=Misdraji J, Yantiss RK, Graeme-Cook FM, Balis UJ, Young RH |title=Appendiceal mucinous neoplasms: a clinicopathologic analysis of 107 cases |journal=Am. J. Surg. Pathol. |volume=27 |issue=8 |pages=1089–103 |year=2003 |month=August |pmid=12883241 |doi= |url=http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=0147-5185&volume=27&issue=8&spage=1089}}</ref> is a good starting point if one is unfamilar with the topic, as it is the least complicated.


===Misdraji classification===
===Misdraji classification of 2003===
*Benign - ''low grade mucinous tumour''.
*Benign - ''low grade mucinous tumour''.
*Borderline - ''mucinous tumour of uncertain malignant potential'' or ''borderline mucinous tumour''.
*Borderline - ''mucinous tumour of uncertain malignant potential'' or ''borderline mucinous tumour''.
Line 97: Line 133:
**Vaguely resemble ''serrations'', i.e. the ''saw-tooth'' pattern in hyperplastic polyps of the colon.
**Vaguely resemble ''serrations'', i.e. the ''saw-tooth'' pattern in hyperplastic polyps of the colon.
*Mucin contained (inside appendix only).
*Mucin contained (inside appendix only).
** mucin extravasation into the appendiceal wall does not upgrade the tumour.
*No marked nuclear atypia.
*No marked nuclear atypia.


Line 113: Line 150:
Image: Mucinous cystadenoma of the appendix - alt -- high mag.jpg | Mucinous cystadenoma - high mag. (WC)
Image: Mucinous cystadenoma of the appendix - alt -- high mag.jpg | Mucinous cystadenoma - high mag. (WC)
Image: Mucinous cystadenoma of the appendix -- very high mag.jpg | Mucinous cystadenoma - very high mag. (WC)
Image: Mucinous cystadenoma of the appendix -- very high mag.jpg | Mucinous cystadenoma - very high mag. (WC)
Image: Appendix LowGradeMucinousNeoplasm MucinousNeoplasm LowGrade LP PA.JPG|Low Grade Appendiceal Mucinous Neoplasm - low power (SKB)
Image: Appendix LowGradeMucinousNeoplasm LP-2 PA.JPG|Low Grade Appendiceal Mucinous Neoplasm -  mucin extravasation into the appendiceal wall- low power (SKB)
Image: Appendix LowGradeMucinousNeoplasm LP - Copy PA.JPG|Low Grade Appendiceal Mucinous Neoplasm - mucin extravasation into the appendiceal wall - low power (SKB)
Image: Appendix LowGradeMucinousNeoplasm MucinousNeoplasm LowGrade HP (2) PA.JPG|Low Grade Appendiceal Mucinous Neoplasm - medium power (SKB)
Image: Appendix LowGradeMucinousNeoplasm MucinousNeoplasm LowGrade HP PA.JPG|Low Grade Appendiceal Mucinous Neoplasm - high power (SKB)
Image: Appendix LowGradeMucinousNeoplasm LP 14BR***.jpg|Low Grade Appendiceal Mucinous Neoplasm - low power (SKB)
Image: Appendix LowGradeMucinousNeoplasm MP 14BR***.jpg|Low Grade Appendiceal  Mucinous Neoplasm - medium power (SKB)
</gallery>
</gallery>


Line 134: Line 179:
VERMIFORM APPENDIX, APPENDECTOMY:
VERMIFORM APPENDIX, APPENDECTOMY:
- LOW-GRADE APPENDICEAL MUCINOUS NEOPLASM.
- LOW-GRADE APPENDICEAL MUCINOUS NEOPLASM.
-- NEGATIVE FOR EXTRA-APPENDICEAL MUCIN.
-- MARGINS NEGATIVE FOR MUCINOUS NEOPLASM.
- ACUTE APPENDICITIS.
- ACUTE APPENDICITIS.
- ACUTE PERIAPPENDICITIS.  
- ACUTE PERIAPPENDICITIS.  
Line 147: Line 194:
</pre>
</pre>


===WHO===
<pre>
<pre>
APPENDIX, APPENDECTOMY:
APPENDIX, APPENDECTOMY:
Michael
48,454

edits

Retrieved from "https://librepathology.org/wiki/Special:MobileDiff/30701...38445"

Navigation menu