Difference between revisions of "Omentum"
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*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: | ||
*** | ***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> | ||
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.
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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:
- Metastatic tumours: stomach, ovary and colon.
- Infection: tuberculous peritonitis.[1]
- 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]
- In the context of a gynecologic malignancy/suspected gynecologic malignancy:
Pathology of the omentum
Benign
Mesothelial:
Other:
Malignant
Primary:
- Malignant mesothelioma.
- Primary peritoneal serous carcinoma.
- Serous tumour of low malignant potential.
- Sarcoma.
- Other Muellerian tumours. (???)
Metastatic:
See also
References
- ↑ 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.
- ↑ 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.
- ↑ 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.