Surgical Pathology Criteria

Pseudomyxoma Peritonei

Differential Diagnosis

Pseudomyxoma Peritonei Peritoneal Carcinomatosis
Primary is mucinous neoplasm of high risk of recurrence of appendix (rarely from teratomas) Primary is mucinous carcinoma of any GI site
Paucicellular implants Implants usually cellular
Non-invasive implants Invasive implants
Low grade cytology May have high grade cytology
Simple or focally proliferative epithelium Complex cribriform epithelium
No signet ring cells May have signet ring component
No nodal or parenchymal metastases (except ovary) Frequent nodal and parenchymal metastases
Many recurrences, eventual fatalily Generally rapidly fatal
The distinction is critical


Pseudomyxoma Peritonei Mucinous Neoplasm with Low Risk of Recurrence with simple mucin extravasation
Epithelial elements in extra-appendiceal mucin deposits No epithelial elements in mucin deposits (must be sectioned extensively)
Many recurrences, eventual fatalily Few cases recur

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