Table of Contents
Definition / general | Microscopic (histologic) description | Microscopic (histologic) images | Positive stains | Differential diagnosisCite this page: Ehdaivand S. Peritoneal implants. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/ovarytumorovarianimplants.html. Accessed January 19th, 2021.
Definition / general
- In patients with primary ovarian tumors, implants are deposits of ovarian tumor on peritoneal surfaces, lateral pelvic gutters, right side of diaphragm or omentum, usually close to primary
- Entire peritoneum may contain tumor nodules < 1 cm, resembling miliary tuberculosis
- Implants are seen in 1/3 of patients with serous borderline tumors, mortality is 25%; some may arise from peritoneal mesothelium; destructive invasion and cytologic atypia are associated with disease progression
- May regress spontaneously leaving psammoma bodies behind
- Criteria:
- Ovarian carcinoma if multiple peritoneal nodules with features of ovarian serous borderline tumor or carcinoma and some minimal ovarian involvement
- Extraovarian serous carcinoma or papillary tumor of peritoneum if no ovarian involvement
- Criteria for implants associated with primary benign or borderline tumor:
- Invasive: either invasion of underlying normal tissue with infiltrating margin and desmoplastic stroma that resembles low-grade serous carcinoma OR micropapillary architecture or solid epithelial nests surrounded by cleft
- Noninvasive: resembles borderline serous tumor, within submesothelial invaginations and between adipose tissue lobules, or within reactive fibrous stroma with variable inflammation
- Invasion by these criteria is associated with adverse outcome (Am J Surg Pathol 2001;25:419)
- Features that do not correlate with invasion are nuclear atypia, mitoses, calcification, necrosis, and individual cell infiltration of the stroma
Microscopic (histologic) description
- Tufting, stratification, atypia, psammoma bodies
- Invasive cases can have micropapillary pattern and solid epithelial nests surrounded by clefts
Microscopic (histologic) images
AFIP images
Positive stains
- LeuM1, B72.3, CEA
Differential diagnosis
- Benign inclusions: less epithelial proliferation