Difference between revisions of "Tumour deposit"

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#redirect [[Colorectal adenocarcinoma#Tumour deposits]]
A '''tumour deposit''' is a microscopic or macroscopic tumour nodule in the lymphatic drainage bed of the (primary) tumour.
 
It is also known as '''discoutinuous extramural extension''' and '''peritumoral deposit'''.
 
Conceptually, tumour deposits are like the ''[[in-transit metastases]]'' of [[malignant melanoma]]<ref name=pmid19136930>{{Cite journal  | last1 = Puppa | first1 = G. | last2 = Ueno | first2 = H. | last3 = Kayahara | first3 = M. | last4 = Capelli | first4 = P. | last5 = Canzonieri | first5 = V. | last6 = Colombari | first6 = R. | last7 = Maisonneuve | first7 = P. | last8 = Pelosi | first8 = G. | title = Tumor deposits are encountered in advanced colorectal cancer and other adenocarcinomas: an expanded classification with implications for colorectal cancer staging system including a unifying concept of in-transit metastases. | journal = Mod Pathol | volume = 22 | issue = 3 | pages = 410-5 | month = Mar | year = 2009 | doi = 10.1038/modpathol.2008.198 | PMID = 19136930 }}</ref> and [[dermatopathology]].
 
==General==
Definition - TNM/AJCC 7th edition:<ref name=pmid21555695/>
*Microscopic or macroscopic nodule in the lymphatic drainage bed of the tumour.
**No standardized distance (from tumour) criteria are defined.<ref name=pmid24112678>{{Cite journal  | last1 = Ueno | first1 = H. | last2 = Hashiguchi | first2 = Y. | last3 = Shimazaki | first3 = H. | last4 = Shinto | first4 = E. | last5 = Kajiwara | first5 = Y. | last6 = Nakanishi | first6 = K. | last7 = Kato | first7 = K. | last8 = Maekawa | first8 = K. | last9 = Nakamura | first9 = T. | title = Peritumoral deposits as an adverse prognostic indicator of colorectal cancer. | journal = Am J Surg | volume =  | issue =  | pages =  | month = Oct | year = 2013 | doi = 10.1016/j.amjsurg.2013.04.009 | PMID = 24112678 }}</ref>
*No findings suggestive of it being a lymph node replaced by tumour:
*#No significant lymphoid tissue.
*#Irregular contour.
*#*Round nodules of tumour are considered lymph nodes that are replaced by tumour.
 
Significance:
*Poor prognosticator.
**Can be understood as a type of invasive front/border, e.g. ''well-circumscribed border'' versus ''infiltrative border''.<ref name=pmid24112678/>
 
Staging implications:
*Tumour deposits are '''not''' counted as (positive) lymph nodes<ref name=pmid21555695>{{Cite journal  | last1 = Nagtegaal | first1 = ID. | last2 = Tot | first2 = T. | last3 = Jayne | first3 = DG. | last4 = McShane | first4 = P. | last5 = Nihlberg | first5 = A. | last6 = Marshall | first6 = HC. | last7 = Påhlman | first7 = L. | last8 = Brown | first8 = JM. | last9 = Guillou | first9 = PJ. | title = Lymph nodes, tumor deposits, and TNM: are we getting better? | journal = J Clin Oncol | volume = 29 | issue = 18 | pages = 2487-92 | month = Jun | year = 2011 | doi = 10.1200/JCO.2011.34.6429 | PMID = 21555695 }}</ref> and in the context of positive lymph nodes do not change the [[Colorectal_cancer_staging#Nodal_stage|N stage]].
**If no positive lymph nodes are present, the N stage is pN1c.
*The T stage is ''not'' affected by tumour deposits.<ref name=pmid21555695/>
 
Notes:
*The definition of ''tumour deposit'' has changed significantly between the TMN/AJCC fifth, sixth and seventh editions.<ref name=pmid21555695/>
*Lesions that are ''not'' in the drainage bed of tumour are [[Colorectal_cancer_staging#Metastasis_stage|metastatic disease]], pM1b.
===Ueno criteria===
Ueno ''et al.'' propose that a tumour deposit is either:<ref name=pmid24112678/>
#>=2 mm from the tumour front.
#>=2 mm (radially) from the deepest aspect of the muscularis propria, if the tumour is not present in the plane of section.
 
==See also==
*[[Colorectal carcinoma]].
*[[Metastasis]].
 
==References==
{{Reflist|1}}
 
[[Category:Gastrointestinal pathology]]

Revision as of 16:50, 10 August 2016

A tumour deposit is a microscopic or macroscopic tumour nodule in the lymphatic drainage bed of the (primary) tumour.

It is also known as discoutinuous extramural extension and peritumoral deposit.

Conceptually, tumour deposits are like the in-transit metastases of malignant melanoma[1] and dermatopathology.

General

Definition - TNM/AJCC 7th edition:[2]

  • Microscopic or macroscopic nodule in the lymphatic drainage bed of the tumour.
    • No standardized distance (from tumour) criteria are defined.[3]
  • No findings suggestive of it being a lymph node replaced by tumour:
    1. No significant lymphoid tissue.
    2. Irregular contour.
      • Round nodules of tumour are considered lymph nodes that are replaced by tumour.

Significance:

  • Poor prognosticator.
    • Can be understood as a type of invasive front/border, e.g. well-circumscribed border versus infiltrative border.[3]

Staging implications:

  • Tumour deposits are not counted as (positive) lymph nodes[2] and in the context of positive lymph nodes do not change the N stage.
    • If no positive lymph nodes are present, the N stage is pN1c.
  • The T stage is not affected by tumour deposits.[2]

Notes:

  • The definition of tumour deposit has changed significantly between the TMN/AJCC fifth, sixth and seventh editions.[2]
  • Lesions that are not in the drainage bed of tumour are metastatic disease, pM1b.

Ueno criteria

Ueno et al. propose that a tumour deposit is either:[3]

  1. >=2 mm from the tumour front.
  2. >=2 mm (radially) from the deepest aspect of the muscularis propria, if the tumour is not present in the plane of section.

See also

References

  1. ↑ Puppa, G.; Ueno, H.; Kayahara, M.; Capelli, P.; Canzonieri, V.; Colombari, R.; Maisonneuve, P.; Pelosi, G. (Mar 2009). "Tumor deposits are encountered in advanced colorectal cancer and other adenocarcinomas: an expanded classification with implications for colorectal cancer staging system including a unifying concept of in-transit metastases.". Mod Pathol 22 (3): 410-5. doi:10.1038/modpathol.2008.198. PMID 19136930.
  2. ↑ 2.0 2.1 2.2 2.3 Nagtegaal, ID.; Tot, T.; Jayne, DG.; McShane, P.; Nihlberg, A.; Marshall, HC.; Påhlman, L.; Brown, JM. et al. (Jun 2011). "Lymph nodes, tumor deposits, and TNM: are we getting better?". J Clin Oncol 29 (18): 2487-92. doi:10.1200/JCO.2011.34.6429. PMID 21555695.
  3. ↑ 3.0 3.1 3.2 Ueno, H.; Hashiguchi, Y.; Shimazaki, H.; Shinto, E.; Kajiwara, Y.; Nakanishi, K.; Kato, K.; Maekawa, K. et al. (Oct 2013). "Peritumoral deposits as an adverse prognostic indicator of colorectal cancer.". Am J Surg. doi:10.1016/j.amjsurg.2013.04.009. PMID 24112678.
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