Clinicopathological Characteristics of Low-Grade Appendiceal Mucinous Neoplasm

2021 ◽  
pp. 1-8
Author(s):  
Tatsuro Yamaguchi ◽  
Kohei Murata ◽  
Tetsuya Shiota ◽  
Hiroshi Takeyama ◽  
Shingo Noura ◽  
...  
Keyword(s):  
Distant Metastasis ◽  
Clinicopathological Characteristics ◽  
Complete Resection ◽  
Low Grade ◽  
Mucinous Neoplasm ◽  
Node Metastasis ◽  
Appendiceal Neoplasms ◽  
Mucinous Neoplasms ◽  
Mucinous Epithelium ◽  
The Difference

Introduction: Recently, “low-grade appendiceal mucinous neoplasms” (LAMNs) have been proposed as one subtype of appendiceal mucinous neoplasms, characterized by a villous or flat proliferation of mucinous epithelium with low-grade cytologic atypia. The aim of this study was to clarify the clinicopathological characteristics of LAMN. Methods: In this multi-institutional cohort study, we retrospectively analyzed the clinicopathological characteristics in appendiceal neoplasms patients who underwent treatment from 2000 to 2017. Results: In total, 922 patients were enrolled, with 279 (30.3%) cases of LAMN, and 93 (10.1%) cases of non-LAMN disease. In comparison with patients with non-LAMN disease, those with LAMN had significantly lower levels of CA19-9 (p = 0.045), a lower frequency of T4 tumors (p < 0.0001), a lower frequency of lymph node metastasis (p < 0.0001), and a lower frequency of distant metastasis (p < 0.0001). Survival analysis revealed that patients with LAMN had a significantly better prognosis than did those with non-LAMN disease (p < 0.001). Among the patients with distant metastasis, those with LAMN had a significantly better prognosis than did those with non-LAMN disease (p = 0.0020), but among the patients without distant metastasis, the difference between the 2 groups was not significant (p = 0.26). However, among patients who underwent complete resection, the difference in prognosis between the 2 groups was not significant (p = 0.10). Conclusions: A multicenter retrospective study revealed that the clinicopathological characteristics of LAMN was different from those of non-LAMN.

EP.FRI.999 Case report of a Low Grade appendiceal mucinous neoplasm (LAMN) and review of literature

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Kimberly Da Costa ◽  
Sivakumaran Sabanathan
Keyword(s):  
Intraperitoneal Chemotherapy ◽  
Pseudomyxoma Peritonei ◽  
Right Hemicolectomy ◽  
Low Grade ◽  
Mucinous Neoplasm ◽  
Mucinous Neoplasms ◽  
Mucocele Of The Appendix ◽  
Preoperative Ct ◽  
Inflammatory Processes ◽  
Progressive Accumulation

Abstract A mucocele refers to an appendix that has dilated due to progressive accumulation of mucus within its lumen. Appendiceal mucocele is a rare cause of an acute abdomen. They represent 0.2-0.7% of all appendix specimens. LAMN account for less than 0.3% of appendicectomy specimens.  We present a 38 year old man with an acute RIF’s pain who went on to have CT scan which revealed a mucocele of appendix but did not show any features of perforation or pseudomyxoma peritonei. He had a laparoscopic converted to open appendicectomy. The proximal 2 cm of appendix was oedematous but normal calibre. Histology revealed a low grade appendiceal mucinous neoplasm (LAMN) that was completely excised.  The mucocele of the appendix was first described by Rokitansky in 1842. Appendix mucocele may come as a consequence of obstructive or inflammatory processes, cystadenomas or cystadenocarcinomas. Appendiceal mucinous neoplasms commonly presents in the sixth decade of life and our patient was much younger in comparison. Several literatures suggest the value of preoperative CT imaging in obtaining diagnosis and also in planning further treatment. Appendicectomy or a right hemicolectomy is treatment of choice based on presence or absence of following factors 1. Perforated mucocele 2. Involvement of the base of the appendix. 3. Positive lymph nodes of mesoappendix and ileocolic. Patients with malignancy or pseudomyxoma peritonei are likely to require cytoreductive surgery, heated intraoperative intraperitoneal chemotherapy, early postoperative intraperitoneal chemotherapy.

The Prognosis and Clinicopathological Characteristics of Metaplastic Breast Cancer: A Meta-Analysis.

2021 ◽  
Author(s):  
Xiaolu Yang ◽  
Tao Zhou
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Distant Metastasis ◽  
Histological Grade ◽  
Meta Analysis ◽  
Clinicopathological Characteristics ◽  
Tnm Staging ◽  
Tumor Diameter ◽  
Metaplastic Breast Cancer ◽  
Node Metastasis

Abstract Background: Due to the rarity of metaplastic breast cancer (MBC), the prognosis and clinicopathologic-al characteristics of MBC patients are still inconclusive. Large-sample retrospective analysis is still lacking at present.This study aims to conduct a meta-analysis of relevant literature on MBC at home and abroad to obtain the prognostic and clinicopathological characteristics of MBC.Methods: Cohort studies or case-control studies comparing MBC and triple-negative breast cancer (TNBC) were searched through the internet, and the quality of the included studies was evaluated using the Newcastle-Ottawa scale (NOS). A total of 9 studies with NOS scores of > 6 were included. Meta-analysis was performed using the Review Manager 5.3 provided by the Cochrane Collaboration Network. The hazard ratio (HR) evaluate the disease-free survival (DFS) and overall survival (OS), and the odds ratio (OR) was used to evaluate clinicopathological characteristics, including age, tumor diameter, lymph node metastasis status, distant metastasis status, TNM staging, and histological grade. According to the heterogeneity of the included studies, random effects model or fixed effects model was used.Results: Compared with TNBC patients, the HR value for 5-year DFS and 5-year OS of MBC patients was 1.64 (95%CI: 1.36-1.98) and 1.52 (95%CI: 1.27-1.81), respectively. The total OR value for age> 50 years old, tumor diameter ≤ 2cm, lymph node positive, distant metastasis, TNM stage III and above, and histological grade 3 was 1.63 (95%CI: 1.45-1.84), 0.29 (95% CI: 0.14-0.58), 0.68 (95%CI: 0.53-0.88), 1.59 (95%CI: 0.89-2.81), 1.49 (95 %CI: 0.80-2.77), and 2.25 (95%CI: 0.85-5.97), respectively.Conclusion: MBC patients are less likely to have lymph node metastasis and had worse DFS and OS than TNBC patients, which may be related to the pathological characteristics of MBC patients being related to sarcoma. But this also requires verification and further research with large sample sizes. In addition, there were no statistical differences in distant metastasis, TNM staging, and histological grade between MBC and TNBC patients.

K-RAS, B-RAF and GNAS Gene Status and Immunohistochemistry Analysis of Mucinous Neoplasm of Appendix

2020 ◽  
Author(s):  
xinyu ren ◽  
Yin Cheng ◽  
Tao Lu ◽  
Junliang Lu ◽  
Yan Wu ◽  
...  
Keyword(s):  
Low Grade ◽  
Cytokeratin 20 ◽  
Ki 67 ◽  
P53 Expression ◽  
Mucinous Neoplasm ◽  
Mucin Expression ◽  
Gnas Gene ◽  
Serrated Lesions ◽  
The Difference ◽  
Gene Status

Abstract AIM Low grade appendiceal mucinous neoplasm (LAMN) and serrated lesions are sometimes hard to differentiate from morphology. We try to characterize them from the immunohistochemical and molecular perspective and to reflect the difference between them. METHODS 25 appendix neoplasm including 13 LAMNs, 12 serrated lesions were selected from January 2013 to December 2014. Immunohistochemical analyses for cytokeratin 20, MUC6, MUC5AC, MUC1, Ki-67, P53 and mismatch repair (MMR) proteins including MLH1, PMS-2, MSH-6, MSH-2 were performed. Microsatellite instability (MSI) status was also evaluated. Besides, we detect K-RAS, B-RAF and GNAS gene mutation status of these lesions. RESULTS Immunochemically, 83.3% serrated lesions showed scattered CK20 staining in the deep crypt, which was less so for LAMNs. As for mucin expression, MUC5AC had slightly higher positive rate in LAMNs and than in serrated lesions.MUC1 was significantly higher expressed in LAMNs than in serrated lesions. 46.1% LAMNs have P53 expression in deep crypt, while P53 was negative in the deep crypt of serrated lesions. 58.3% serrated lesions had deficient MMR protein expresion pattern compared to 23.1% of LAMNs. B-RAF mutation was detected in 3 cases, all were serrated lesions. K-ras and GNAS mutation was detected in both LAMNs and serrated lesions. CONCLUSION Immunohistochemical panel comprising markers such as CK20, MUC5AC, MUC1, Ki-67 and P53, with genotyping covering hotspots of the KRAS, BRAF and GNAS genes can help the differential diagnosis of low grade appendix neoplasm.

scholarly journals A Rare Distant Metastasis of Papillary Cystadenocarcinoma Arising from Maxillary Gingiva

2020 ◽  
Vol 13 (2) ◽  
pp. 683-688
Author(s):  
Fumihiro Nishimaki ◽  
Takahiko Gibo ◽  
Keita Tsukada ◽  
Takuro Noguchi ◽  
Toshirou Fukushima ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Pulmonary Metastasis ◽  
Distant Metastasis ◽  
Regional Lymph Node ◽  
Metastatic Lesion ◽  
Careful Examination ◽  
Low Grade ◽  
Node Metastasis ◽  
Long Term Follow Up

Papillary cystadenocarcinoma is an uncommon disease with low-grade histological and clinical features. Although the tumor has the potential to produce regional lymph node metastasis, there have been no reports of cases with distant metastasis. We describe a case of papillary cystadenocarcinoma arising from the maxilla that developed pulmonary metastasis 3 years after radical surgery of the primary tumor and regional lymph node. The histological findings were confirmed on resected specimens of the pulmonary nodule and a pathological diagnosis of a metastatic lesion derived from papillary cystadenocarcinoma was made. To our knowledge, this is the first report of the development of pulmonary metastasis in a patient with papillary cystadenocarcinoma. The present case suggests that papillary cystadenocarcinoma has the potential to produce lung metastasis in the clinical course. Based on our experience, we emphasize that long-term follow-up and/or careful examination are necessary in patients with cystadenocarcinoma, especially in patients with lymph node metastasis during the initial surgical therapy.

scholarly journals Low-Grade Appendiceal Mucinous Neoplasm Involving the Endometrium and Presenting with Mucinous Vaginal Discharge

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Vera Vavinskaya ◽  
Joel M. Baumgartner ◽  
Albert Ko ◽  
Cheryl C. Saenz ◽  
Mark A. Valasek
Keyword(s):  
Pseudomyxoma Peritonei ◽  
Vaginal Discharge ◽  
Low Grade ◽  
Invasive Adenocarcinoma ◽  
Peritoneal Disease ◽  
Mucinous Neoplasm ◽  
Mucinous Neoplasms ◽  
Pathological Evaluation ◽  
Classification Management

Primary appendiceal mucinous lesions are uncommon and represent a spectrum from nonneoplastic mucous retention cysts to invasive adenocarcinoma. Low-grade appendiceal mucinous neoplasms (LAMNs) represent an intermediate category on this spectrum and can be classified according to whether or not they are confined to the appendix. Although LAMNs are frequently confined to the appendix, they can also spread to the peritoneum and clinically progress as pseudomyxoma peritonei (i.e., mucinous ascites). Thus, the appropriate classification of appendiceal primary neoplasia is essential for prognosis and influences clinical management. In addition, the precise classification, management, and clinical outcome of patients with disseminated peritoneal disease remain controversial. Here, we report an unusual case of LAMN with pseudomyxoma peritonei that initially presented with mucinous and bloody vaginal discharge. Pathological evaluation revealed low-grade appendiceal mucinous neoplasm with secondary involvement of the peritoneum, ovaries, and endometrial surface. Therefore, LAMN should be considered in the differential diagnosis of mucinous vaginal discharge.

scholarly journals Expression of miR-21 in Colorectal Cancer and Its Relationship with Clinicopathological Characteristics of Colorectal Cancer

2020 ◽  
Vol 3 (3) ◽  
pp. 40
Author(s):  
Jia Lei
Keyword(s):  
Colorectal Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Clinicopathological Characteristics ◽  
Control Group ◽  
Cancer Tissue ◽  
Study Group ◽  
Node Metastasis ◽  
The Difference ◽  
Tissue Specimens

Objective: To investigate the expression of miR-21 in colorectal cancer cells, and to analyze the relationship between the level of miR-21 and the clinicopathological characteristics of colorectal cancer patients. Methods: 210 patients with colorectal cancer treated in our hospital from January 2016 to June 2019 were selected. Cancer tissue specimens (study group) and adjacent normal tissue specimens (control group) were surgically collected, and the quantitative quantitative PCR was used to detect and compare the miR-21 expression of the two groups. Results: The expression of miR-21 in the study group was higher than that in the control group, and the difference was statistically significant (P <0.05). There were significant differences among patients with early and intermediate TNM, patients with low differentiation and patients with moderate to high differentiation, patients with lymph node metastasis and patients without lymph node metastasis, patients with high infiltration and patients with low infiltration, patients with high CEA levels, and patients with low CEA, and the difference was statistically significant (P <0.05). Conclusion: In colorectal cancer, miR-21 is highly expressed, which is closely related to stage and differentiation, and can be used to reflect the patient’s condition.

scholarly journals Detection of BRCA1/2 Mutation and Analysis of Clinicopathological Characteristics in 141 Cases of Ovarian Cancer

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Ling Li ◽  
Fangfang Chen ◽  
An Lin ◽  
Di Wang ◽  
Yi Shi ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Lymph Node ◽  
Distant Metastasis ◽  
Age Of Onset ◽  
Clinical Information ◽  
Clinicopathological Characteristics ◽  
High Grade ◽  
Brca1 And Brca2 ◽  
Serous Adenocarcinoma ◽  
Node Metastasis

Breast cancer susceptibility genes 1 and 2 (BRCA1 and BRCA2) are known biomarkers for hereditary ovarian cancer (OC). However, a comprehensive association study between BRCA1/2 mutation spectrum and clinicopathological characteristics in Chinese ovarian cancer patients has not been performed yet to our best knowledge. To fill in this gap, we collected BRCA1/2 sequencing data and clinical information of 141 OC patients from Fujian Cancer Hospital between April 2018 and March 2020. The clinical information includes the age of onset, FIGO staging, pathological types, serum 125 detection level, lymph node metastasis, distant metastasis, the expression of Ki67, and disease history of the patient and his/her family. We then studied their associations by software SciPy 1.0. As a result, we detected pathogenic and potentially pathogenic BRCA1/2 mutations in 27 out of 141 patients (19.15%). Among the 27 patients with mutations, the major type of mutation was frameshift, which was observed in 12 patients (44.4%). Most of the mutation sites were distributed on exons 10 and 11, accounting for 48.1% (13/27) and 22.2% (6/27), respectively. In terms of histological classification, high-grade serous adenocarcinoma accounted for 79.43% of the 141 samples. The BRCA1/2 mutation group was all high-grade serous adenocarcinoma, accounting for 24.1% (27/112) of this group. The incidence of pathogenic mutation in BRCA1 and BRCA2 was 15.7% (19/112) and 7.27% (8/112), respectively. Univariate analysis showed that there was no significant difference between patients with BRCA1/2 mutation and others in age-of-onset, FIGO stage, pathological types, serum CA125 level, lymph node metastasis, the expression of Ki67, and personal and family disease history. However, there are significant differences between patients with BRCA1/2 mutation and others in distant metastasis rate ( P < 0.002 ). In addition, the BRCA1/2 mutation rate in 141 ovarian cancer patients was similar to those reported in other studies in China. Nearly one-quarter of high-grade serous carcinomas had BRCA1/2 mutations. In conclusion, our study indicated that patients with BRCA1/2 mutations were more likely to undergo distant metastasis, and BRCA1/2 mutation detection should be performed for patients with high-grade serous adenocarcinoma to guide the selection of clinical treatment options.

scholarly journals Risk Factors, Prognostic Factors, and Nomogram for Distant Metastasis in Breast Cancer Patients Without Lymph Node Metastasis

2021 ◽  
Vol 12 ◽  
Author(s):  
Yu Min ◽  
Xiaoman Liu ◽  
Daixing Hu ◽  
Hang Chen ◽  
Jialin Chen ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Cancer Patients ◽  
Distant Metastasis ◽  
Clinicopathological Characteristics ◽  
Risk Level ◽  
Breast Cancer Patients ◽  
Node Metastasis

BackgroundLymph node negative (N0) breast cancer can be found coexisting with distant metastasis (DM), which might consequently make clinicians underestimate the risk of relapse and insufficient treatment for this subpopulation.MethodsThe clinicopathological characteristics of N0 breast cancer patients from the Surveillance, Epidemiology, and End Results (SEER) database between January 2010 and December 2015 were retrospectively reviewed. Multivariate logistic and Cox analyses were used to identify independent risk factors in promoting DM and the 1-, 3-, and 5- year cancer-specific survival (CSS) in this subpopulation.ResultSeven factors including age (&lt;40 years), tumor size (&gt;10 mm), race (Black), location (central), grade (poor differentiation), histology (invasive lobular carcinoma), and subtype (luminal B and Her-2 enriched) were associated with DM, and the area under curve (AUC) was 0.776 (95% CI: 0.763–0.790). Moreover, T1-3N0M1 patients with age &gt;60 years at diagnosis, Black race, triple-negative breast cancer subtype, no surgery performed, and multiple DMs presented a worse 1-, 3-, and 5-year CSS. The areas under the ROC for 1-, 3-, and 5- year CSS in the training cohort were 0.772, 0.741, and 0.762, respectively, and 0.725, 0.695, and 0.699 in the validation cohort.ConclusionThe clinicopathological characteristics associated with the risk of DM and the prognosis of female breast cancer patients without lymph node metastasis but with DM are determined. A novel nomogram for predicting 1-, 3-, 5- year CSS in T1-3N0M1 patients is also well established and validated, which could help clinicians better stratify patients who are at a high-risk level for receiving relatively aggressive management.

scholarly journals The utility of PAX8 and SATB2 immunohistochemical stains in distinguishing ovarian mucinous neoplasms from colonic and appendiceal mucinous neoplasm

2019 ◽  
Vol 12 (1) ◽  
Author(s):  
Najla Aldaoud ◽  
Madiha Erashdi ◽  
Sohaib AlKhatib ◽  
Nour Abdo ◽  
Alia Al-Mohtaseb ◽  
...  
Keyword(s):  
Gastrointestinal Tract ◽  
Colorectal Carcinoma ◽  
High Specificity ◽  
Low Grade ◽  
Lower Gastrointestinal Tract ◽  
Mucinous Neoplasm ◽  
Mucinous Neoplasms ◽  
Low Sensitivity ◽  
Sensitive Marker ◽  
Immunohistochemical Stains

Abstract Objectives It is challenging to distinguish between primary ovarian mucinous tumors and metastatic mucinous neoplasms from the lower gastrointestinal tract, including appendiceal tumors. A combination of PAX8 and SATB2 immunohistochemical stains can be used as a diagnostic tool to distinguish between these cases. Results Immunostaining for SATB2, PAX8, CK7, CK20 and CDX2 was performed on 50 ovarian mucinous neoplasms (OMN) (39 cystadenomas, 4 borderline and 7 adenocarcinomas), 63 mucinous colorectal carcinoma (CRC), and 9 appendiceal mucinous neoplasms (AMN) [8 low grade appendiceal mucinous neoplasms (LAMN) and 1 adenocarcinoma]. PAX8 was positive in 32% of OMN and negative in all CRC and AMN cases. SATB2 was expressed in 2.0% of OMN, 77.8% of AMN, and 49.2% of CRC cases. CK7 was positive in 78.0% of OMN, 33.3% of AMN, and 9.5% of CRC cases. CK20 was expressed in 24.0% of OMN, 88.9% of OMN, and 87.3% of CRC cases. CDX2 was positive in 14.0% of OMN, 100% of AMN, and 90.5% of CRC cases. PAX8 can differentiate between OMN and AMN with high specificity but low sensitivity. CDX2 is the most sensitive marker for CRC and AMN, whereas SATB2 has better specificity.

scholarly journals Rare Cases of Low-Grade Appendiceal Mucinous Neoplasm: Two Case Reports and a Literature Review

2019 ◽  
Vol 12 (2) ◽  
pp. 488-493
Author(s):  
Senichiro Yanagawa ◽  
Hisaaki Yoshinaka ◽  
Hidehiro Tanji ◽  
Shinya Kodama ◽  
Yukio Takeshima ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Abdominal Pain ◽  
Surgical Technique ◽  
Case Reports ◽  
Low Grade ◽  
Lower Quadrant ◽  
Mucinous Neoplasm ◽  
Appendiceal Mucocele ◽  
Mucinous Neoplasms ◽  
Right Lower Quadrant

Appendiceal mucocele (AM) is rare disease found in <1% of all appendectomy specimens. AM is often misdiagnosed as appendicitis because the most frequent symptom is right lower quadrant abdominal pain. AM should be considered in the differential diagnosis of abdominal pain. Although there are pathological classifications, surgical resection is accepted as the treatment to prevent the development of peritoneal pseudomyxoma (PP); however, the optimal surgical technique that must be used is unclear. We present two cases suspected of being AM prior to surgery that were pathologically diagnosed as low-grade appendiceal mucinous neoplasms. Each case progressed without developing PP. The surgical procedures we chose are considered appropriate for each case.

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