Appendix - Mucinous neoplasms/(cyst)adenocarcinoma

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Appendix

Carcinoma

Mucinous neoplasms/(cyst)adenocarcinoma

Reviewer: Jaleh Mansouri, M.D. (see Reviewers page)
Revised: 21 October 2012, last major update August 2012
Copyright: (c) 2003-2012, PathologyOutlines.com, Inc.

General
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● Resembles ovarian tumor, 20% as common as cystadenoma
● May present with pain due to distention of the viscus
● Associated with pseudomyxoma peritonei, particularly if it ruptures

Gross description
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● May have appearance of mucocele, cystadenoma
● Often associated with pseudomyxoma peritonei

Micro description
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● Malignant cells (destructive invasion of appendiceal wall, extensive full-thickness nuclear stratification, vesicular nuclei, marked nuclear membrane abnormalities, prominent nucleoli, frequent mitotic figures, complex papillary fronds, cribriform glandular spaces) in wall with desmoplastic stromal response (high-grade mucinous adenocarcinoma)
● Some authors also classify as malignant if epithelial cells (which may appear benign) in peritoneal mucinous deposits (low-grade mucinous adenocarcinoma)
● Term low-grade mucinous neoplasm/mucinous neoplasm of uncertain malignant potential may be used in cases of well-differentiated mucinous neoplasm without evidence of frank invasion (presence of undulating or broad front) or absence of tumor cells in mucin deposits

Micro images
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Well-differentiated mucinous adenocarcinoma

Molecular description
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● 18q-

Positive stains
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● CK18, CK20, CEA, CDX2, MUC2

Differential diagnosis
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● Mucocele, (cyst)adenoma, tumors with mucinous differentiation from other primary sites

Additional references
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● Arch Pathol Lab Med 2010;134:1612

End of Appendix > Carcinoma > Mucinous neoplasms/(cyst)adenocarcinoma

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