Indian Journal of Pathology and Microbiology
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Year : 2022  |  Volume : 65  |  Issue : 3  |  Page : 565-571

Mucinous appendiceal neoplasms and pseudomyxoma peritonei: Morphological and clinical findings, differential diagnosis, and prognosis

1 Department of Pathology, Kayseri City Training and Research Hospital, Kayseri, Turkey
2 Department of Radiation Oncology, Kayseri City Education and Research Hospital, Kayseri, Turkey
3 Department of General Surgery, Kayseri City Training and Research Hospital, Kayseri, Turkey
4 Department of Medical Oncology, Kayseri City Training and Research Hospital, Kayseri, Turkey

Correspondence Address:
Ebru Akay
Kayseri City Training and Research Hospital, Pathology, 38100 Kocasinan/Kayseri
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijpm.ijpm_827_21

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Background: Low-grade appendiceal mucinous neoplasms (LAMN) of the appendix have bland cytological features and well-differentiated morphology. Despite this, they may cause a pseudomyxoma peritonei (PMP) disease characterized by mucinous deposits in the peritoneal cavity and may exhibit malignant behavior. Aims and Objectives: In this study, we evaluated the clinical course and histopathological findings of LAMN. The rate of progression to PMP, factors affecting its development, and the clinical course of cases with PMP were investigated. Materials and Methods: Twelve thousand and forty-seven cases who underwent appendectomy were reviewed, and 71 mucinous lesions cases whose slides are in our archive were included in the study. Histopathological findings were re-evaluated. Morphological findings that guide the differential diagnosis, the clinical course of the patients, and factors affecting PMP development were determined. Results: The cases were divided into group 1 non-neoplastic (9.9%), group 2 benign (18.3%), group 3 LAMN (60.6), and group 4 malignant neoplasms (11.3%). Age, gender, appendix diameter, gross appearance, epithelial characteristics, and presence of microcalcification were significantly different between the patient groups. The presence of mucin in the ileocecal region was found to be significant in the development of PMP. It was observed that the additional procedure performed after the appendectomy did not prevent a recurrence. Conclusion: LAMNs are lesions with characteristic findings and different behaviors. The only method to distinguish from the lesions included in the differential diagnosis is to interpret the histopathological findings correctly. Additional operations after appendectomy do not contribute to preventing recurrence.

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