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Difference between revisions of "Neuroendocrine tumour of the appendix"
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Neuroendocrine tumour of the appendix (view source)
Revision as of 07:35, 19 March 2015
, 07:35, 19 March 2015no edit summary
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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, | **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 | **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 | *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 | |||
===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 also== | ==See also== | ||