Difference between revisions of "Mucinous borderline tumour of the ovary"

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#redirect[[Ovarian tumours#Mucinous borderline tumour of the ovary]]
'''Mucinous borderline tumour of the ovary''' is an [[ovarian tumour]] with a low malignant potential.


It is also known as '''ovarian mucinous borderline tumour''' and '''ovarian mucinous tumour of low malignant potential'''.<ref name=pmid21464732>{{Cite journal  | last1 = Khunamornpong | first1 = S. | last2 = Settakorn | first2 = J. | last3 = Sukpan | first3 = K. | last4 = Suprasert | first4 = P. | last5 = Siriaunkgul | first5 = S. | title = Mucinous tumor of low malignant potential (borderline or atypical proliferative tumor) of the ovary: a study of 171 cases with the assessment of intraepithelial carcinoma and microinvasion. | journal = Int J Gynecol Pathol | volume = 30 | issue = 3 | pages = 218-30 | month = May | year = 2011 | doi = 10.1097/PGP.0b013e3181fcf01a | PMID = 21464732 }}</ref>
==General==
*Requires extensive sampling - to avoid missing an adenocarcinoma.
Note:
*The WHO prefers ''borderline'' over ''low malignant potential'' as the descriptor for these tumours.<ref name=pmid16100867>{{Cite journal  | last1 = Acs | first1 = G. | title = Serous and mucinous borderline (low malignant potential) tumors of the ovary. | journal = Am J Clin Pathol | volume = 123 Suppl | issue =  | pages = S13-57 | month = Jun | year = 2005 | doi =  | PMID = 16100867 }}</ref>
===Classification===
Subdivided into:<ref name=pmid15371946>{{Cite journal  | last1 = Rodriguez | first1 = IM. | last2 = Irving | first2 = JA. | last3 = Prat | first3 = J. | title = Endocervical-like mucinous borderline tumors of the ovary: a clinicopathologic analysis of 31 cases. | journal = Am J Surg Pathol | volume = 28 | issue = 10 | pages = 1311-8 | month = Oct | year = 2004 | doi =  | PMID = 15371946 }}</ref>
# Intestinal type mucinous borderline tumour of the ovary ~ 90% of cases.
# Endocervical type mucinous borderline tumour of the ovary ~ 10% of cases.<ref name=Ref_GP419>{{Ref GP|419}}</ref>
==Gross==
''Intestinal type mucinous borderline tumour of the ovary'' and ''endocervical type mucinous borderline tumour of the ovary'':
*Complex multiloculated mass with mucin.
*Often large - may > 30 cm.
==Microscopic==
===Intestinal type mucinous borderline tumour of the ovary===
Features:
*Mucinous differentiation:
**Tall [[columnar cell]]s with apical mucin - usu. resembles gastric foveolar epithelium.
*Layering of epithelial cells (stratification).
**Must be <= 3 cells.<ref name=Ref_GP416>{{Ref GP|416}}</ref>
*+/-Papillary infoldings.
**Projections into the cystic space.
*+/-Mild nuclear atypia.
*+/-Mitoses (focally).
Notes:
#Resembles a [[villous adenoma]] of the [[colon]].<ref name=Ref_GP>{{Ref GP|416}}</ref>
#Borderline component must be >= 10% of the tumour.<ref name=Ref_GP>{{Ref GP|416}}</ref>
#*Lesions with <10% borderline component are known as ''[[mucinous cystadenoma of the ovary]] with focal proliferation'' or ''[[mucinous cystadenoma of the ovary]] with focal atypia''.
DDx:
*[[Mucinous adenocarcinoma of the ovary]].
*[[Mucinous cystadenoma of the ovary]].
*[[Mucinous cystadenoma of the ovary]] with focal proliferation.
<!-- Images: -->
===Endocervical type mucinous borderline tumour of the ovary===
Features:<ref name=Ref_GP420>{{Ref GP|420}}</ref>
#Cells with mucinous differentiation resembling endocervical epithelium:
#*Tall [[columnar cell]]s with grey apical mucin.
#Cells with eosinophilic cytoplasm - known as "pink cells".
#Ciliated cells.
*Neutrophils associated with the epithelium/mucin - common.<ref>URL: [http://www.webpathology.com/image.asp?n=12&Case=526 http://www.webpathology.com/image.asp?n=12&Case=526]. Accessed on: 9 January 2013.</ref>
<!-- Images: -->
===Comparing intestinal versus endocervical===
{| class="wikitable sortable"
! Feature
! Intestinal
! Endocervical
|-
| Primary mucin producing cell
| clear - well-diff. component, eosinophilic (pink)
| eosinophilic (pink), grey or clear
|-
| Size
| tall columnar (height:width >3:1) "champagne flute"
| stubby columnar (height:width <3:1)
|-
| Accompanying epithelial cells
| +/-goblet cells
| pink cells, ciliated cells
|-
| Other cells
| none
| neutrophils (intraepithelial) - common
|-
| Images
|
|
|}
==Molecular==
*[[KRAS mutation]]s common ~ 73% of mucinous borderline tumours in one series.<ref name=pmid9118042>{{Cite journal  | last1 = Cuatrecasas | first1 = M. | last2 = Villanueva | first2 = A. | last3 = Matias-Guiu | first3 = X. | last4 = Prat | first4 = J. | title = K-ras mutations in mucinous ovarian tumors: a clinicopathologic and molecular study of 95 cases. | journal = Cancer | volume = 79 | issue = 8 | pages = 1581-6 | month = Apr | year = 1997 | doi =  | PMID = 9118042 }}</ref>
==Sign out==
<pre>
OVARY AND CYST, LEFT, OOPHORECTOMY:
- MUCINOUS BORDERLINE TUMOUR, INTESTINAL TYPE, ARISING FROM A MUCINOUS CYSTADENOMA (INTESTINAL TYPE).
- OVARIAN PARENCHYMA.
</pre>
==See also==
*[[Ovarian tumours]].
==References==
{{Reflist|1}}
[[Category:Gynecologic pathology]]
[[Category:Diagnosis]]
[[Category:Diagnosis]]

Latest revision as of 16:39, 1 March 2018

Mucinous borderline tumour of the ovary is an ovarian tumour with a low malignant potential.

It is also known as ovarian mucinous borderline tumour and ovarian mucinous tumour of low malignant potential.[1]

General

  • Requires extensive sampling - to avoid missing an adenocarcinoma.

Note:

  • The WHO prefers borderline over low malignant potential as the descriptor for these tumours.[2]

Classification

Subdivided into:[3]

  1. Intestinal type mucinous borderline tumour of the ovary ~ 90% of cases.
  2. Endocervical type mucinous borderline tumour of the ovary ~ 10% of cases.[4]

Gross

Intestinal type mucinous borderline tumour of the ovary and endocervical type mucinous borderline tumour of the ovary:

  • Complex multiloculated mass with mucin.
  • Often large - may > 30 cm.

Microscopic

Intestinal type mucinous borderline tumour of the ovary

Features:

  • Mucinous differentiation:
    • Tall columnar cells with apical mucin - usu. resembles gastric foveolar epithelium.
  • Layering of epithelial cells (stratification).
    • Must be <= 3 cells.[5]
  • +/-Papillary infoldings.
    • Projections into the cystic space.
  • +/-Mild nuclear atypia.
  • +/-Mitoses (focally).

Notes:

  1. Resembles a villous adenoma of the colon.[6]
  2. Borderline component must be >= 10% of the tumour.[6]

DDx:


Endocervical type mucinous borderline tumour of the ovary

Features:[7]

  1. Cells with mucinous differentiation resembling endocervical epithelium:
  2. Cells with eosinophilic cytoplasm - known as "pink cells".
  3. Ciliated cells.
  • Neutrophils associated with the epithelium/mucin - common.[8]


Comparing intestinal versus endocervical

Feature Intestinal Endocervical
Primary mucin producing cell clear - well-diff. component, eosinophilic (pink) eosinophilic (pink), grey or clear
Size tall columnar (height:width >3:1) "champagne flute" stubby columnar (height:width <3:1)
Accompanying epithelial cells +/-goblet cells pink cells, ciliated cells
Other cells none neutrophils (intraepithelial) - common
Images

Molecular

Sign out

OVARY AND CYST, LEFT, OOPHORECTOMY:
- MUCINOUS BORDERLINE TUMOUR, INTESTINAL TYPE, ARISING FROM A MUCINOUS CYSTADENOMA (INTESTINAL TYPE).
- OVARIAN PARENCHYMA.

See also

References

  1. ↑ Khunamornpong, S.; Settakorn, J.; Sukpan, K.; Suprasert, P.; Siriaunkgul, S. (May 2011). "Mucinous tumor of low malignant potential (borderline or atypical proliferative tumor) of the ovary: a study of 171 cases with the assessment of intraepithelial carcinoma and microinvasion.". Int J Gynecol Pathol 30 (3): 218-30. doi:10.1097/PGP.0b013e3181fcf01a. PMID 21464732.
  2. ↑ Acs, G. (Jun 2005). "Serous and mucinous borderline (low malignant potential) tumors of the ovary.". Am J Clin Pathol 123 Suppl: S13-57. PMID 16100867.
  3. ↑ Rodriguez, IM.; Irving, JA.; Prat, J. (Oct 2004). "Endocervical-like mucinous borderline tumors of the ovary: a clinicopathologic analysis of 31 cases.". Am J Surg Pathol 28 (10): 1311-8. PMID 15371946.
  4. ↑ Nucci, Marisa R.; Oliva, Esther (2009). Gynecologic Pathology: A Volume in Foundations in Diagnostic Pathology Series (1st ed.). Churchill Livingstone. pp. 419. ISBN 978-0443069208.
  5. ↑ Nucci, Marisa R.; Oliva, Esther (2009). Gynecologic Pathology: A Volume in Foundations in Diagnostic Pathology Series (1st ed.). Churchill Livingstone. pp. 416. ISBN 978-0443069208.
  6. ↑ 6.0 6.1 Nucci, Marisa R.; Oliva, Esther (2009). Gynecologic Pathology: A Volume in Foundations in Diagnostic Pathology Series (1st ed.). Churchill Livingstone. pp. 416. ISBN 978-0443069208.
  7. ↑ Nucci, Marisa R.; Oliva, Esther (2009). Gynecologic Pathology: A Volume in Foundations in Diagnostic Pathology Series (1st ed.). Churchill Livingstone. pp. 420. ISBN 978-0443069208.
  8. ↑ URL: http://www.webpathology.com/image.asp?n=12&Case=526. Accessed on: 9 January 2013.
  9. ↑ Cuatrecasas, M.; Villanueva, A.; Matias-Guiu, X.; Prat, J. (Apr 1997). "K-ras mutations in mucinous ovarian tumors: a clinicopathologic and molecular study of 95 cases.". Cancer 79 (8): 1581-6. PMID 9118042.
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