Department of Medical and Surgical Sciences, Institute of Pathology, University Hospital of Modena, Modena (MO), Italy.
Department of Medical and Surgical Sciences, Section of Surgery, University Hospital of Modena, Modena (MO), Italy.
Adv Exp Med Biol. 2020;1226:87-95. doi: 10.1007/978-3-030-36214-0_7.
The pathological features of the appendix tumors fundamentally recall those of the more frequent colorectal neoplasms, although with a higher relative incidence of carcinoids, due to the abundant presence of enteroendocrine cells in the appendix wall. Moreover, different types of lymphomas, Hodgkin and non-Hodgkin, arising from the extra-nodal mucosal-associated lymphatic tissue, can be encountered. The appendix tumor microenvironment (TME) consists of a cellular component and of a noncellular component: the former includes the immunocompetent cells, while the latter represents the support stroma. Particularly in carcinoids, the immune cell reaction can be explicated by tumor-infiltrating lymphocytes, which, in some circumstances, may arrange around and inside the tumor in a brisk fashion influencing favorably the prognosis. This active reaction has to be distinguished from any preexisting inflammatory condition of the appendix and from superimposed tumor complications, such as infection or ischemia. In practice, we consider the appendix TME a complex framework with immunological, mechanic, and metabolic functions, all supported by a marked neo-lymphoangiogenesis.
阑尾肿瘤的病理学特征从根本上与更常见的结直肠肿瘤相似，尽管类癌的相对发病率较高，这是由于阑尾壁中丰富的肠内分泌细胞所致。此外，还可能会遇到源自结外黏膜相关淋巴组织的不同类型的淋巴瘤，包括霍奇金淋巴瘤和非霍奇金淋巴瘤。阑尾肿瘤的微环境（TME）由细胞成分和非细胞成分组成：前者包括免疫活性细胞，后者代表支持基质。特别是在类癌中，肿瘤浸润淋巴细胞可以解释免疫细胞反应，在某些情况下，这些淋巴细胞可能会迅速围绕肿瘤排列，并在肿瘤内排列，从而对预后产生有利影响。这种活跃的反应需要与阑尾的任何先前存在的炎症情况以及肿瘤的并发症（如感染或缺血）区分开来。实际上，我们认为阑尾 TME 是一个具有免疫、机械和代谢功能的复杂框架，所有这些功能都由明显的新淋巴管生成支持。
