Appendix Tumor Microenvironment

  • Luca Roncati
  • Paolo Gasparri
  • Graziana Gallo
  • Giuditta Bernardelli
  • Giuliana Zanelli
  • Antonio Manenti
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 1226)


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.


Appendix Tumor microenvironment Cancer Adenocarcinoma Signet-ring cell carcinoma Mucocele Carcinoid Neuroendocrine tumor Tumor-infiltrating lymphocytes (TILs) Brisk Non-brisk Immune score Lymphoma High-grade large B-cell lymphoma MALToma 


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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Luca Roncati
    • 1
  • Paolo Gasparri
    • 1
  • Graziana Gallo
    • 1
  • Giuditta Bernardelli
    • 1
  • Giuliana Zanelli
    • 1
  • Antonio Manenti
    • 2
  1. 1.Department of Medical and Surgical SciencesInstitute of Pathology, University Hospital of ModenaModena (MO)Italy
  2. 2.Department of Medical and Surgical SciencesSection of Surgery, University Hospital of ModenaModena (MO)Italy

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