Tang classification

Goblet cell carcinoid

Carcinoid

Adenocarcinoma

Clinical features

Age

5th - 6th decade

4th decade

7th decade

Carcinoid syndrome

No

Yes

No

Primary symptoms

Acute appendicitis

Acute appendicitis

Mass

Gross appearance

>2 cm, ill defined thickening

<2 cm

>2 cm, well defined mass

Microscopic appearance

Morphology

Clusters of goblet or signet-ring cells separated by fibrosis/pools of mucin

Nests of small cells

Well-formed glands to sheets of poorly differentiated signet-ring cells

Atypia

Minimal

Minimal

Marked

Mitosis

Rare

Rare

Increased

Vascular and perineural invasion

Present

Absent

Present

Infiltrative margins

Present

Absent

Present

Special stains

Argyrophil

Positive

Positive

Usually negative

Argentaffin

Negative

Positive

Negative

Mucicarmine/PAS/PASD

Positive in goblet cells

Negative

Positive

IHC

CEA

+

+

CDX2

+

+

CAM5.2

+

+

CK20

+/−

+

CK7

+/−

CK19

+

Neuroendocrine markers

+/−

+/−

Math1 and HD5

+

+

p53, p16

+

Molecular pathology

DPC4, Kras, β-catenin mutation and p53 over expression

+