Radiology Expression of MUC1 and MUC2 mucin gene products in Barretts metaplasia, dysplasia and adenocarcinoma: an immunopathological study with clinical correlation. S-100 is also only positive in <1% of gastric GISTs (57). Accessibility about navigating our updated article layout. Pyogenic splenic abscess can be seen as an isolated involvement of the spleen or as part of a systemic involvement. Biopsies can be done using ultrasound or computed tomography (CT). Polypoid squamous cell carcinoma of the esophagus. Radiographics. Aaltonen LA, Salovaara R, Kristo P, et al. FOIA Lung adenocarcinoma is further classified into several 2. Cystic or necrotic degeneration can occur in metastasis; this is usually seen in metastasis from melanoma and the lesions appear as unilocular or multilocular cystic lesions with septations[16]. It refers to infiltration of the normal omental structure by other types of soft-tissue or chronic inflammation resulting in a thickened, or cake-like appearance. Pancreatic cancer is more common among the elderly, with a higher incidence in men than in women and more common in blacks compared to other races (137). The increase in p53 expression is accompanied by increased Ki-67 labeling (26,27).
Omental cake Pancreatic ductal carcinomas often present as poorly defined masses involving the head of the pancreas (>60%) with variable degrees of necrosis which may lead to the formation of cysts (139). Predisposing factors include male gender, white race, obesity, Barretts esophagus, smoking and alcohol consumption (32). Morphologic and immunohistochemical observations on the mammary and extramammary Pagets disease: implications for the histogenesis. Splenic lymphangiomatosis in children. CDX-2 expression in pseudomyxoma peritonei: a clinicopathological study of 42 cases. Cytokeratin 7 and 20 expression in cholangiocarcinomas varies along the biliary tract but still differs from that in colorectal carcinoma metastasis. The etiology and epidemiology of anal cancer. 2) are uncommon, comprising only 5-7% of all intestinal duplications ().The three diagnostic criteria for duplication cysts The so-called bile duct adenoma is a peribiliary gland hamartoma. Cytochemical and clinical aspects. Differential expression of alpha-methylacyl coenzyme A racemase in adenocarcinomas of the small and large intestines. 8). The leading consideration is pseudomyxoma peritonei. It may originate from the ovary itself or more commonly from communicating nearby structures such as fallopian tubes or the inner lining of the abdomen.
Adenocarcinoma of the lung Histologically, well-differentiated HCC is difficult to differentiate from normal liver as the polygonal cells resemble hepatocytes and are arranged in trabecular pattern lined by sinusoids mimicking normal liver but have intracytoplasmic bile (Figure 9A) (188). Pseudomyxoma peritonei also often involves the spleen and is seen as scalloping of the splenic margin (Fig. Primary angiosarcoma of the spleen.
Omental cake Pancreatic ductal adenocarcinomas make up the majority (>95%) of pancreatic tumors. 3. The diagnosis of littoral cell angioma should be suspected when multiple hypodense nodules are seen in a patient with splenomegaly and hypersplenism[2]. Terminology. The classification of mucinous neoplasms within the appendix remains a controversial issue.
Ovarian cancer Portela-Gomes GM, Hacker GW, Weitgasser R. Neuroendocrine cell markers for pancreatic islets and tumors. Crypt cell carcinoma of the appendix (so-called adenocarcinoid tumor). On MRI, littoral cell angiomas may show low signal intensity on all sequences similar to siderotic nodules due to hemosiderin accumulation within neoplastic littoral cells[24]. Bethesda, MD 20894, Web Policies Mucinous neoplasms of the appendix and peritoneum. Mixed exocrine-endocrine tumor of the pancreas. Ultrasound. Immunohistochemistry in the differential diagnosis between primary and secondary intestinal adenocarcinoma of the urinary bladder. It is classified as one of several non-small cell lung cancers (NSCLC), to distinguish it from small cell lung cancer which has a different behavior and prognosis.
Renal cell carcinoma Cytokeratins 7 and 20, Dpc4, and MUC5AC in the distinction of metastatic mucinous carcinomas in the ovary from primary ovarian mucinous tumors: Dpc4 assists in identifying metastatic pancreatic carcinomas. Gastrointestinal tract tumors include a wide variety of vastly different tumors and on a whole are one of the most common malignancies in western countries. On magnetic resonance imaging (MRI) these lesions are isointense on precontrast T1- and T2-weighted sequences, but hypointense on post-contrast sequences. Bearzi I, Brancorsini D, Santinelli A, et al. Determining the site of origin of mucinous adenocarcinoma: an immunohistochemical study of 175 cases. Categories of HPCC include: (I) Familial adenomatous polyposis; (II) MUTYH-associated polyposis; (III) hyperplastic polyposis syndrome; (IV) Peutz-Jeghers syndrome; and (V) Juvenile polyposis syndrome (89). Accessibility Risk factors include cigarette smoking, family history, diabetes mellitus and obesity (138). Email: Kamaya A, Weinstein S, Desser TS. Direct tumor invasion of the spleen is uncommon, but can be seen in tumors originating from the pancreas, stomach, colon or left kidney and retroperitoneum ( Fig. The Society of Gynecologic Oncology (SGO) is the premier medical specialty society for health care professionals trained in the comprehensive management of gynecologic cancers. Adenocarcinoma of the lung is the most common type of lung cancer, and like other forms of lung cancer, it is characterized by distinct cellular and molecular features. Histologically, these tumors are similar to colorectal adenocarcinomas and are characterized by the degree of pleomorphism, complex glandular architecture, luminal necrosis and invasion. Masses on the peritoneal surfaces and malignant ascitesmay also be present. The complete type of GIM is negative for MUC1 and MUC5AC but positive for MUC2 while incomplete GIM is positive for both (22). MRI. Despite its short length, the anal canal produces a wide variety of tumor types. The diagnosis of dysplasia and malignancy in Barretts oesophagus. These implants are seen on CT to cause indentation and scalloping of the surface of the spleen. Immunoreactivity of cytokeratins (CK7, CK20) and mucin peptide core antigens (MUC1, MUC2, MUC5AC) in adenocarcinomas, normal and metaplastic tissues of the distal oesophagus, oesophago-gastric junction and proximal stomach. The sonographic appearance of splenic metastasis is variable with most appearing hypoechoeic.
Hepatocellular carcinoma The neuroendocrine products of intestinal carcinoids. Patients may present with dysphagia, odynophagia and weight loss. Multimodality imaging of Hodgkin disease and non-Hodgkin lymphomas in children. Diagnosis of HNPCC is based on the Amsterdam criteria taking into account the extracolonic malignancies which are common in HNPCC involving the endometrium, stomach, ovary, urinary collecting system, skin, pancreatic and biliary tract (97). A. CK7 positivity; B. CK20; C. CDX-2showing diffuse positivity. As a 501(c)(6) organization, the SGO contributes to the advancement of women's cancer care by encouraging research, providing education, raising standards of practice, advocating Adenocarcinoma of ampulla of Vater comprise about 5-6% of cancers arising (69) in the head of the pancreas. 11). SPNs are generally large, well circumscribed tumors which can occur anywhere within the pancreas (160). PanIN is the most common and most defined precursor lesion of pancreatic ductal carcinoma (145). Falk S, Stutte HJ, Frizzera G. Littoral cell angioma. and transmitted securely. CA is characterized by a CK7 negative and CK20 positive (Figure 6B) immunophenotype, and thus can be differentiated from non-ampullary small intestinal adenocarcinomas by their lack of expression of CK7 and positivity for CK20,Table 2 summarizes several key immunohistochemical stains which can help in distinguishing these two entities. In additional to its unique morphologic features, IM also shows a unique immunohistochemical profile. Most of them follow the signal intensity of simple fluid on MRI, but few cysts may demonstrate a high T1 signal due to proteinaceous or hemorrhagic content[16]. The clinical history is usually corroborative of an infectious cause in these cases. Omental cake refers to infiltration of the omental fat by material of soft-tissue density. Mixed exocrine-endocrine tumors are defined as malignant epithelial neoplasms where the ductal and endocrine cells are intimately mixed in the primary tumor with at least one-third to one-half of tumor cells showing positivity for endocrine markers (185). Although rare, angiosarcoma is the most common primary non-hematopoietic malignant tumor of the spleen[7]. Contrast-enhanced CT scan shows multiple well-defined cystic lesions in the perisplenic region invaginating into the spleen (arrows) in a patient with known pseudomyxoma peritonei. Histologically, the tumor has a lobular appearance with well-defined islands of small epithelial cells separated by fibrous bands with a geographic pattern of lighter and darker staining cells due to the different cell types present. Of the malignant lesions metastatic tumors are far more common than primary hepatocellular carcinomas. On ultrasound, hamartomas are usually seen as well-circumscribed homogeneous solid masses[18]. Primary splenic lymphoma usually represents non-Hodgkin lymphoma of B cell origin.
Esophageal cancer These tumors have a mutation of the -catenin gene and show a diffuse cytoplasmic and nuclear positivity in virtually all cases by immunohistochemistry (164). Contrast-enhanced CT shows a large exophytic mass arising from the spleen (arrows). PMC legacy view Aberrant CD5 co-expression has been described while co-expression of CD43 has been reported in one-third of cases (62). Benign bile duct proliferations: Benign bile duct proliferations such as bile duct hamartomas (also know as von Meyenburg complexes) and bile duct adenomas are usually small, incidental asymptomatic lesions identified at time of autopsy. Terminology. The incidence and anatomic site specificity of chromosomal translocations in primary extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) in North America. Lam KY, Tang V. Metastatic tumors to the spleen: a 25-year clinicopathologic study. Mucinous neoplasms of the appendix are the most common type of epithelial neoplasms in the appendix. Solid pseudopapillary neoplasms of the pancreas are associated with FLI-1 expression, but not with EWS/FLI-1 translocation. Differential considerations include cystadenoma and cystadenocarcinoma. Pathologic classification and clinical behavior of the spectrum of goblet cell carcinoid tumors of the appendix. (152-154). Multiple tiny nodules in the liver (black arrowheads) and few enlarged lymph nodes along the celiac axis (arrow) are noted in a patient with known sarcoidosis representing hepatosplenic involvement and lymph node enlargement. Taniere P, Borghi-Scoazec G, Saurin JC, et al. Pseudomyxoma peritonei refers to syndrome of progressive intraperitoneal accumulation of mucinous ascites related to a mucin-producing neoplasm.It is most commonly caused by a mucinous tumor of the appendix 10.. Much less commonly, mucinous tumors of colon, rectum, stomach, pancreas, and urachus 9,10,13 are implicated. Pancreatic neuroendocrine tumors (PNETs) are rare neoplasms with an incidence of 1 per 100,000 individuals per year and comprising just 1-2% of all pancreatic tumors (170). Modern Immunohistochemistry. CT of acquired abnormalities of the spleen. The radiological appearance of the tumor reflects its aggressive nature seen on pathology. These tumors are classified according to the WHO classification into well differentiated endocrine tumor, well differentiated endocrine carcinoma and poorly differentiated endocrine carcinoma based on size, mitotic count, Ki-67 proliferation index, angioinvasion and metastasis. Federal government websites often end in .gov or .mil. government site. Cavernous hemangiomas typically show heterogeneous enhancement due to presence of cystic non-enhancing areas within the lesion. Magnetic resonance imaging (MRI) and endoscopic ultrasound (EUS) are primary investigations in diagnosing and following up on these patients. Regression of primary low-grade B-cell gastric lymphoma of mucosa-associated lymphoid tissue type after eradication of Helicobacter pylori. Loss of cell-adhesion molecule complexes in solid pseudopapillary tumor of pancreas.
Peritoneal 16)[38].
Congenital pancreatoblastoma in Beckwith-Wiedemann syndrome: an emerging association. Direct tumor invasion of the spleen is uncommon, but can be seen in tumors originating from the pancreas, stomach, colon or left kidney and retroperitoneum ( Fig. If a candidate is found, it should fulfill the criteria for a cyst: thin wall. Johnson DE, Herndier BG, Medeiros LJ, et al. Mixed exocrine-endocrine tumors of the pancreas. Risk factors for HCC include chronic liver disease such as chronic hepatitis C virus, hepatitis B virus, cirrhosis, obesity related liver disease and alcohol-related liver disease (189). Cytokeratin 7 staining in mammary and extramammary Pagets disease. The location of these carcinoid tumors can be divided based on their embryologic derivation into carcinoids of the foregut (esophagus, stomach and duodenum), midgut (jejunum, ileum, appendix and ascending colon) and hindgut (transverse colon, descending colon, sigmoid and rectum) (71). Contrast-enhanced CT shows splenomegaly with innumerable hypodense nodules in the spleen (white arrowheads). A novel splenic vascular lesion demonstrating histiocytic differentiation. Pancreatic ductal carcinomas are also positive for CK8, CK17 (Figure 8D), CK18, CK19, CEA, CA19-9, Dupan-2, MUC1, MUC4 and MUC5AC (140-143). Mucinous cystic tumors of the pancreas: clinicopathological features, prognosis, and relationship to other mucinous cystic tumors. These tumors are more common in elderly men and have been associated with cirrhosis, hepatitis C, infections by Clonorchis sinesis and Opisthorchisis viverrini, primary sclerosing cholangitis, Thorotrast exposure, genetic hemochromatosis, alpha-1-antitrypsin deficiency and contraceptive steroid use (202-204). Calcification in splenic metastasis is rare unless the primary tumor is a mucinous adenocarcinoma (Fig. Most MCNs also express MUC5AC while MUC-1 is only expressed in invasive MCNs (151). When this happens, your healthcare provider will begin by physically examining you and follow up with imaging tests (radiology). Bile duct adenomas are also small subcapsular nodules consisting of acini and tubules and may be confused for a malignant lesion (212). Differential diagnosis When this happens, your healthcare provider will begin by physically examining you and follow up with imaging tests (radiology). Pancreatic intraepithelial neoplasia (PanIN) has been speculated to be the precursor lesion of pancreatic ductal adenocarcinomas for over fifty years, but it is only recently that its significance and role in pancreatic carcinoma has been established. The use of immunohistochemistry can help differentiate these as those arising from anal gland adenocarcinoma would be CK7+/CK20+/CDX-2+/GCDFP-15- (119,120), from adnexal adenocarcinoma would be CK7+/CK20-/CDX-2-/GCDFP-15+ and that from a colorectal adenocarcinoma would be CK7-/CK20+/CDX-2+/GCDFP-15+- (119-124). A. Colon adenocarcinoma; B. Diffuse CK20 positivity in tumor cells; C. Villin shows diffuse positivity; D. CDX-2 is diffusely positive; E. MUC2 positive in mucin producing cells. Prognostic factors for ampullary adenocarcinomas: tumor stage, tumor histology, tumor location, immunohistochemistry and microsatellite instability. It is a clinical syndrome, characterized by recurrent and recalcitrant voluminous mucinous ascites due to surface growth on the peritoneum without significant invasion of underlying tissues. As a 501(c)(6) organization, the SGO contributes to the advancement of women's cancer care by encouraging research, providing education, raising standards of practice, advocating Splenic hamartoma. Reference article, Radiopaedia.org (Accessed on 22 Nov 2022) https://doi.org/10.53347/rID-1773. The majority of gastric adenocarcinomas is located in the pylorus and antrum (50-60%), followed by the cardia (25%), and the body or fundus (15-25%) and may be exophytic, flat or ulcerated. Immunohistologic analysis of gastrointestinal and pulmonary carcinoid tumors. Somatic glypican 3 (GPC3) mutations in Wilms tumour. Immunohistochemical features of Pagets disease of the vulva with and without adenocarcinoma. Human papillomavirus associated with oesophageal cancer. Cytokeratin expression patterns in noncardia, intestinal metaplasia-associated gastric adenocarcinoma: implication for the evaluation of intestinal metaplasia and tumors at the esophagogastric junction. This information is for patients with pseudomyxoma peritonei (PMP). Most cases show expression of CK7 (Figure 8B), while a subset focally express CK20 (40%) (Figure 8C), a feature which allow for differentiation from extra-pancreatobiliary non-mucinous adenocarcinomas. GIM is similar histologically and immunohistochemically to Barretts esophagus/esophageal adenocarcinoma. These tumors usually express CK7, variable CK20, AMACAR, and weak focal CDX-2, an immunohistochemical pattern similar to that of gastric adenocarcinoma. The mucin profile of noninvasive and invasive mucinous cystic neoplasms of the pancreas. The diagnosis of GIST then requires examination of the morphologic, immunohistochemical and molecular PDGRFRA mutation analysis. CRC is the third most common cancer diagnosed in the United States and third most common cause of cancer deaths. Cytokeratin subset immunostaining in rectal adenocarcinoma and normal anal glands. The .gov means its official. Clinical Radiology is published by Elsevier on behalf of The Royal College of Radiologists.Clinical Radiology is an International Journal bringing you original research, editorials and review articles on all aspects of diagnostic imaging, including: Computed tomography Magnetic resonance imaging Ultrasonography Digital radiology Ruptured ovarian cysts can have a variety of appearances depending on when the rupture took place, and whether the cyst is hemorrhagic or not. Other markers for HCC include CD10 (Figure 10A), polyclonal CEA (Figure 10B) which highlights the canaliculi (198,199), HepPar-1 (Figure 10C) which reacts with both neoplastic and normal liver tissue. 12)[32]. Most cases of gastric carcinoma arise within areas of incomplete GIM, and show CK7 and CK20 in the superficial and deep crypt cells (37-39). Omental cake refers to infiltration of the omental fat by material of soft-tissue density. 14). Other markers shown to be positive in pancreatic endocrine tumors include trypsin, chymotrypsin and lipase (174,175).
gastrointestinal tract tumors rupture: may lead to pseudomyxoma peritonei (mucinous ascites) if the underlying cause is neoplastic 11,12; can act as a lead point and result in an ileocolic intussusception 9; History and etymology. Peliosis of spleen.
Primary and secondary neoplasms The risk of CRC is related to the development of innumerable adenomas. Histologically, IM is quite similar to normal small intestinal mucosa with the presence of absorptive cells, goblet cells and Paneth cells. Following contrast administration, splenic hemangiomas show varying patterns of enhancement with most lesions showing peripheral enhancement in the arterial phase with progressive centripetal fill-in and persistent retention of contrast on the delayed phase (Fig. Histologic and immunohistochemical features of goblet cell carcinoid tumor of the appendix. Pseudomyxoma peritonei accompanied by intraductal papillary mucinous neoplasm of the pancreas. Frequency of CD43 expression in non-Hodgkin lymphoma. Percutaneous nonvascular splenic intervention: a 10-year review. Chapter 6, Tumors of the Digestive System; New York: Cambridge University Press; p188-254. These tumors often present at late stages as distant metastases which are then biopsied and may be difficult to differentiate without the aid of immunohistochemical stains. CDX-2 homeobox gene product expression in neuroendocrine tumors: its role as a marker of intestinal neuroendocrine tumors. The .gov means its official. Studies have show that 15% of low-grade dysplasia may show progression to carcinoma while cases of carcinoma from high-grade dysplasia is seen in 80-85% (34,35). Bradley RF, Stewart JH, 4th, Russell GB, et al. The Society of Gynecologic Oncology (SGO) is the premier medical specialty society for health care professionals trained in the comprehensive management of gynecologic cancers. tuberculous peritonitis may also give this appearance, lymphoma can present as omental caking, diffuse peritoneal thickening, and ascites, the best clue is significant lymphadenopathy, ADVERTISEMENT: Supporters see fewer/no ads, Please Note: You can also scroll through stacks with your mouse wheel or the keyboard arrow keys. GCC is a distinct type of carcinoid tumor within the colorectum which exhibits both neuroendocrine and intestinal-type goblet cell morphology (103). CC arises from the intrahepatic bile duct epithelial cells and can be divided based on the location of origin, intrahepatic/peripheral CC arise at the confluence of the right and left hepatic ducts, while the extrahepatic CC arise between the ampulla of Vater and the hepatic hilium (205). Splenic metastases in a large unselected autopsy series. Esophageal cancer is cancer arising from the esophagusthe food pipe that runs between the throat and the stomach. Hepatocellular carcinoma arising in an adenoma: value of QBend 10 immunostaining in diagnosis of liver cell carcinoma. may have accompanying pseudomyxoma peritonei; MRI. c-erbB-2 oncoprotein expression in mammary and extramammary Pagets disease: an immunohistochemical study. Tumor cells have basally oriented nuclei, single prominent nucleoli and granular cytoplasm.
Intraductal Papillary Mucinous Neoplasm of Pancreas PMC legacy view The presence of occasional squamoid nests is characteristic for this lesion (178). 12 ) [ 32 ] .
Radiology Shimono T, Yamaoka T, Nishimura K, et al. Maves CK, Caron KH, Bisset, 3rd GS, Agarwal R. Splenic and hepatic peliosis: MR findings. Pseudomyxoma peritonei (PMP) is a rare type of cancer. official website and that any information you provide is encrypted (A,B) Contrast-enhanced axial CT images of the spleen show multiple well-defined hypodense lesions (arrowheads) ranging in size from 5mm to 3cm. van Dorst EB, van Muijen GN, Litvinov SV, et al. Doglioni C, Wotherspoon AC, Moschini A, et al. Functional neuroendocrine tumors are tumors which produce a variety of clinical syndromes due to an excess in hormones and include insulinoma, gastrinoma, glucagonoma, VIPoma, and somatostatinoma (171). They most often occur in the ileum and rarely in the duodenum and can be separated by their location: duodenal and jejunoilieal carcinoids. 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