Neuroendocrine tumour of the appendix - Revision history

Michael: /* Sign out */ tweak

2019-08-22T14:41:54Z

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← Older revision		Revision as of 14:41, 22 August 2019
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	The low-grade neuroendocrine tumour (in the planes of section) is in the tip and		The low-grade neuroendocrine tumour (in the planes of section) is in the tip and
	separate from the appendiceal perforation site/acute appendicitis.		separate from the appendiceal perforation site/acute appendicitis.

			The specimen was submitted in total.
	</pre>		</pre>

Michael: /* Presentation */

2019-08-19T17:59:33Z

Presentation

← Older revision		Revision as of 17:59, 19 August 2019
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	Management:		Management:
	*Simple resection, e.g. appendectomy, sufficient for most tumours <2 cm.<ref>{{Cite journal \| last1 = Nussbaum \| first1 = DP. \| last2 = Speicher \| first2 = PJ. \| last3 = Gulack \| first3 = BC. \| last4 = Keenan \| first4 = JE. \| last5 = Ganapathi \| first5 = AM. \| last6 = Englum \| first6 = BR. \| last7 = Tyler \| first7 = DS. \| last8 = Blazer \| first8 = DG. \| title = Management of 1- to 2-cm Carcinoid Tumors of the Appendix: Using the National Cancer Data Base to Address Controversies in General Surgery. \| journal = J Am Coll Surg \| volume = 220 \| issue = 5 \| pages = 894-903 \| month = May \| year = 2015 \| doi = 10.1016/j.jamcollsurg.2015.01.005 \| PMID = 25840530 }}</ref><ref>{{Cite journal \| last1 = Fornaro \| first1 = R. \| last2 = Frascio \| first2 = M. \| last3 = Sticchi \| first3 = C. \| last4 = De Salvo \| first4 = L. \| last5 = Stabilini \| first5 = C. \| last6 = Mandolfino \| first6 = F. \| last7 = Ricci \| first7 = B. \| last8 = Gianetta \| first8 = E. \| title = Appendectomy or right hemicolectomy in the treatment of appendiceal carcinoid tumors? \| journal = Tumori \| volume = 93 \| issue = 6 \| pages = 587-90 \| month = \| year = \| doi = \| PMID = 18338494 }}</ref>		*Simple resection, e.g. appendectomy, sufficient for most tumours <2 cm.<ref name=pmid25840530>{{Cite journal \| last1 = Nussbaum \| first1 = DP. \| last2 = Speicher \| first2 = PJ. \| last3 = Gulack \| first3 = BC. \| last4 = Keenan \| first4 = JE. \| last5 = Ganapathi \| first5 = AM. \| last6 = Englum \| first6 = BR. \| last7 = Tyler \| first7 = DS. \| last8 = Blazer \| first8 = DG. \| title = Management of 1- to 2-cm Carcinoid Tumors of the Appendix: Using the National Cancer Data Base to Address Controversies in General Surgery. \| journal = J Am Coll Surg \| volume = 220 \| issue = 5 \| pages = 894-903 \| month = May \| year = 2015 \| doi = 10.1016/j.jamcollsurg.2015.01.005 \| PMID = 25840530 }}</ref><ref name=pmid18338494>{{Cite journal \| last1 = Fornaro \| first1 = R. \| last2 = Frascio \| first2 = M. \| last3 = Sticchi \| first3 = C. \| last4 = De Salvo \| first4 = L. \| last5 = Stabilini \| first5 = C. \| last6 = Mandolfino \| first6 = F. \| last7 = Ricci \| first7 = B. \| last8 = Gianetta \| first8 = E. \| title = Appendectomy or right hemicolectomy in the treatment of appendiceal carcinoid tumors? \| journal = Tumori \| volume = 93 \| issue = 6 \| pages = 587-90 \| month = \| year = \| doi = \| PMID = 18338494 }}</ref>

	==Gross==		==Gross==

Michael: /* Presentation */

2019-08-19T17:59:05Z

Presentation

← Older revision		Revision as of 17:59, 19 August 2019
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	*<1.0 cm - do not metastasize.		*<1.0 cm - do not metastasize.
	*1.0-2.0 cm - rarely metastasize.		*1.0-2.0 cm - rarely metastasize.

			Management:
			*Simple resection, e.g. appendectomy, sufficient for most tumours <2 cm.<ref>{{Cite journal \| last1 = Nussbaum \| first1 = DP. \| last2 = Speicher \| first2 = PJ. \| last3 = Gulack \| first3 = BC. \| last4 = Keenan \| first4 = JE. \| last5 = Ganapathi \| first5 = AM. \| last6 = Englum \| first6 = BR. \| last7 = Tyler \| first7 = DS. \| last8 = Blazer \| first8 = DG. \| title = Management of 1- to 2-cm Carcinoid Tumors of the Appendix: Using the National Cancer Data Base to Address Controversies in General Surgery. \| journal = J Am Coll Surg \| volume = 220 \| issue = 5 \| pages = 894-903 \| month = May \| year = 2015 \| doi = 10.1016/j.jamcollsurg.2015.01.005 \| PMID = 25840530 }}</ref><ref>{{Cite journal \| last1 = Fornaro \| first1 = R. \| last2 = Frascio \| first2 = M. \| last3 = Sticchi \| first3 = C. \| last4 = De Salvo \| first4 = L. \| last5 = Stabilini \| first5 = C. \| last6 = Mandolfino \| first6 = F. \| last7 = Ricci \| first7 = B. \| last8 = Gianetta \| first8 = E. \| title = Appendectomy or right hemicolectomy in the treatment of appendiceal carcinoid tumors? \| journal = Tumori \| volume = 93 \| issue = 6 \| pages = 587-90 \| month = \| year = \| doi = \| PMID = 18338494 }}</ref>

	==Gross==		==Gross==

Michael: /* IHC */

2019-08-19T17:49:30Z

IHC

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	Others:		Others:
	*CK7 and CK20 variable.<ref name=pmid22461652>{{Cite journal \| last1 = Matsukuma \| first1 = KE. \| last2 = Montgomery \| first2 = EA. \| title = Tubular carcinoids of the appendix: the CK7/CK20 immunophenotype can be a diagnostic pitfall. \| journal = J Clin Pathol \| volume = 65 \| issue = 7 \| pages = 666-8 \| month = Jul \| year = 2012 \| doi = 10.1136/jclinpath-2011-200639 \| PMID = 22461652 }}</ref>		*CK7 and CK20 variable.<ref name=pmid22461652>{{Cite journal \| last1 = Matsukuma \| first1 = KE. \| last2 = Montgomery \| first2 = EA. \| title = Tubular carcinoids of the appendix: the CK7/CK20 immunophenotype can be a diagnostic pitfall. \| journal = J Clin Pathol \| volume = 65 \| issue = 7 \| pages = 666-8 \| month = Jul \| year = 2012 \| doi = 10.1136/jclinpath-2011-200639 \| PMID = 22461652 }}</ref>

			==Sign out==
			<pre>
			Vermiform Appendix, Appendectomy:
			- Low-grade neuroendocrine tumour (carcinoid tumour), see comment.
			-- Margins clear.
			-- Please see synoptic report.
			- Perforated acute appendicitis with periappendicitis.

			Comment:
			The tumour stains as follows:
			POSITIVE: AE1/AE3, chromogranin A, synaptophysin, CD56.
			NEGATIVE: CK7, CK20, S100.
			PROLIFERATION (Ki-67): <3%.

			The low-grade neuroendocrine tumour (in the planes of section) is in the tip and
			separate from the appendiceal perforation site/acute appendicitis.
			</pre>

	==See also==		==See also==

Michael: /* IHC */

2015-03-30T19:02:48Z

IHC

← Older revision		Revision as of 19:02, 30 March 2015
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	*Chromogranin A -ve/+ve.		*Chromogranin A -ve/+ve.
	*Synaptophysin +ve.		*Synaptophysin +ve.
	*Keratin positive~~, but CK7/CK20 negative~~.{{fact}}		*Keratin positive.{{fact}}
	*S100 positive for appendix.{{fact}}		*S100 positive for appendix.{{fact}}

			Others:
			*CK7 and CK20 variable.<ref name=pmid22461652>{{Cite journal \| last1 = Matsukuma \| first1 = KE. \| last2 = Montgomery \| first2 = EA. \| title = Tubular carcinoids of the appendix: the CK7/CK20 immunophenotype can be a diagnostic pitfall. \| journal = J Clin Pathol \| volume = 65 \| issue = 7 \| pages = 666-8 \| month = Jul \| year = 2012 \| doi = 10.1136/jclinpath-2011-200639 \| PMID = 22461652 }}</ref>

	==See also==		==See also==

Michael: /* Gross */

2015-03-19T07:39:43Z

Gross

← Older revision		Revision as of 07:39, 19 March 2015
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	==Gross==		==Gross==
	*Classically found in the tip of the appendix.		*Classically found in the tip of the appendix.
	*Characteristic yellow cut surface ~~(when fixed)~~		*Characteristic yellow cut surface post-[[fixation]].
	*Circumscribed but not encapsulated		*Circumscribed but not encapsulated.
	*Firm (due to desmoplasia)		*Firm (due to desmoplasia).
	*Centred in the submucosa		*Centred in the submucosa.
	*Nodules that do not usually cause erosion of the overlying mucosa.		*Nodules that do not usually cause erosion of the overlying mucosa.

Michael at 07:38, 19 March 2015

2015-03-19T07:38:44Z

← Older revision		Revision as of 07:38, 19 March 2015
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	'''Neuroendocrine tumour of the appendix''' is a common tumour of the [[vermiform appendix]]. It is also known as '''appendiceal neuroendocrine tumour''', abbreviated '''appendiceal NET'''.		'''Neuroendocrine tumour of the appendix''' is a common tumour of the [[vermiform appendix]]. It is also known as '''appendiceal neuroendocrine tumour''', abbreviated '''appendiceal NET'''.

	It was previously known as ''appendiceal carcinoid''.		It was previously known as '''appendiceal [[carcinoid]]'''.

	==General==		==General==

Michael at 07:36, 19 March 2015

2015-03-19T07:36:50Z

← Older revision		Revision as of 07:36, 19 March 2015
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	'''Neuroendocrine tumour of the appendix''' is a common tumour of the [[vermiform appendix]].		'''Neuroendocrine tumour of the appendix''' is a common tumour of the [[vermiform appendix]]. It is also known as '''appendiceal neuroendocrine tumour''', abbreviated '''appendiceal NET'''.

			It was previously known as ''appendiceal carcinoid''.

	==General==		==General==

Michael at 07:35, 19 March 2015

2015-03-19T07:35:25Z

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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, ~~rosettes~~		**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, coarse 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 ~~aka~~ [[~~Crypt~~ cell carcinoma]]		*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

	~~DDx:~~
	*[[Colorectal adenocarcinoma]].
	*Adenocarcinoid.
	*[[Crypt cell carcinoma]] (goblet cell carcinoid).
	*Metastatic adenocarcinoma.
	*Normal ganglion cells in the Meissner plexus (submucosa) and Auerbach plexus (located between the inner and outer layers of the muscularis propria).

	===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: ''''~~.

	==See also==		==See also==

Michael: /* See also */

2015-03-19T07:29:28Z

← Older revision		Revision as of 07:29, 19 March 2015
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	==See also==		==See also==
	*[[Vermiform appendix]].		*[[Vermiform appendix]].
	*[[~~[[neuroendocrine~~ tumours]].		*[[Neuroendocrine tumours]].

	==References==		==References==