appendix


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  • Normal

    • mucosa
      • mucinous columnar epithelium
      • MALT
      • goblet cells
      • paneth cells
    • muscularis mucosa
    • submucosa
    • muscularis propria
      • circular layer
      • nerves
      • longitudinal layer
    • subserosa
    • serosa
    • mesoappendix
  • Non-neoplastic

  • WHO neoplasms

  • TNM (useful for grossing)

    • carcinoma
      • Tis: in situ or lamina propria invasion
      • T1: submucosa invasion
      • T2: muscularis invasion
      • T3: subserosa or mesoappendix
      • T4: serosa perforation or adjacent organ invasion
        • T4a: serosa perforation, including mucinous peritoneal tumor in RLQ
        • T4b: adjacent structure or organ invasion
      • N1: 1-3 nodes
      • N2: 4+ nodes
      • M1: intraperitoneal metastasis beyond RLQ, including pseudomyxoma peritonei
      • M2: nonperitoneal metastasis
    • carcinoid
      • T1: size <= 2 cm
        • T1a: size <= 1 cm
        • T1b: size <= 2 cm
      • T2: size <= 4 cm or cecum extension
      • T3: size > 4 cm or ileum extension
      • T4: serosa perforation or adjacent structure invasion
  • Staging

    • carcinoma
      • 0: Tis
      • I: T1-2
      • IIA: T3
      • IIB: T4a
      • IIC: T4b
      • IIIA: T1-2 N1
      • IIIB: T3-4 N1
      • IIIC: N2
      • IVA: N0 M1a G1
      • IVB: N0 M1a G2-4 or N1-2 M1a
      • IVC: M1b
    • carcinoid
      • I: T1
      • II: T2-3
      • III: T4 or N1
      • IV: M1