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Difference between revisions of "Vermiform appendix"
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→Mucinous tumour: rework
m (→Neuroendocrine tumour of the appendix: +atl.) |
(→Mucinous tumour: rework) |
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*Like ''colorectal adenocarcinoma'' - see ''[[colorectal tumours]]''. | *Like ''colorectal adenocarcinoma'' - see ''[[colorectal tumours]]''. | ||
==Mucinous tumour== | ==Mucinous tumour of the appendix== | ||
General | |||
* | ===General=== | ||
** | *Classification is controversial. | ||
* | **The controversy centres on whether to call all mucinous tumours outside of the appendix adenocarcinoma - regardless of whether they have atypia & show invasion. | ||
** | *In women - an ovarian primary must be excluded. | ||
**Concurrent ''bilateral'' ovarian tumours suggests the tumour originated from the appendix and spread to the ovaries. | |||
Classification:<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> | Classification:<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> | ||
*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''. | ||
* | *Malignant - ''mucinous adenocarcinoma''. | ||
Five year survival (in a series of 107 cases):<ref name=pmid12883241/> | Five year survival (in a series of 107 cases):<ref name=pmid12883241/> | ||
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|100% | |100% | ||
|- | |- | ||
|LAMN | |LAMN extra-appendiceal spread | ||
|86% | |86% | ||
|- | |- | ||
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|} | |} | ||
*LAMN = low-grade appendiceal mucinous neoplasm. | *LAMN = low-grade appendiceal mucinous neoplasm. | ||
*LAMN | *LAMN extra-appendiceal = low-grade appendiceal mucinous neoplasm with extra-appendiceal spread. | ||
*MACA = mucinous adenocarcinoma. | *MACA = mucinous adenocarcinoma of the appendix. | ||
===Microscopic=== | |||
====Low-grade appendiceal mucinous neoplasm==== | |||
*[[AKA]] ''benign mucinous tumour of the appendix''. | |||
Microscopic: | Microscopic: | ||
*Epithelium forms ''tufts'' - vaguely resemble ''serrations'', i.e. the ''saw-tooth'' pattern in hyperplastic polyps. | *Epithelium forms ''tufts'' - vaguely resemble ''serrations'', i.e. the ''saw-tooth'' pattern in hyperplastic polyps. | ||
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*No invasion into the lamina propria. | *No invasion into the lamina propria. | ||
=== | ====Low-grade appendiceal mucinous neoplasm with extra-appendiceal spread==== | ||
*[[AKA]] ''mucinous borderline tumour of the appendix''. | |||
Microscopic: | Microscopic: | ||
*Same as | *Same as LAMN but mucin outside of the appendix. | ||
*Cells in mucin, i.e. cellular mucin. | *Cells in mucin, i.e. cellular mucin. | ||
=== | ====Mucinous adenocarcinoma of the appendix==== | ||
*[[AKA]] ''malignant mucinous tumour of the appendix''. | |||
Microscopic: | Microscopic: | ||
*Marked nuclear pleomorphism. | *Marked nuclear pleomorphism. | ||
*Invasion into the wall. | *Invasion into the appendiceal wall. | ||
==Goblet cell carcinoid== | ==Goblet cell carcinoid== | ||