Histologically, there is an exuberant growth of epithelial cells

distributed on many layers, with clusters of cells detached from

and mitotic
activity is occasionally present without
exceeding 4 mitoses per 10 hpf. There is no
the papillae. Nuclear atypia is mild to moderate

invasion of the adjacent stroma (Fig. 6.5). Tangential cuts that

show epithelial cells surrounded by stroma have to be
distinguished from true invasion.

According to other studies, the presence of a micropapillary

pattern is less significant for the prognosis than the rather
uncommonly encountered invasive peritoneal implants.[16]
They are more often associated with peritoneal implants,
representing stage II or III borderline ovarian tumors. Peritoneal
implants are noninvasive or invasive, the latter being
characterized by a more aggressive behavior. Noninvasive
implants, epithelial or desmoplastic, resemble the papillary
structures of the ovarian borderline tumor forming
circumscribed lesions on the surface or in the septa of the
omental adipose tissue, often surrounded by an inflammatory
reaction (Fig. 6.7). Invasive implants have irregular borders with
destruction of the adipose tissue, exhibiting higher degree of
nuclear atypia and small rounded nests of epithelial cells.
Noninvasive and invasive implants can occur in the same
patient.