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T1 Age 2 13 46-year-old T2 Sex 14 19 woman T3 Clinical_event 20 29 presented E1 Clinical_event:T3 T4 Severity 35 41 severe T5 Detailed_description 42 47 acute T6 Sign_symptom 48 52 pain E2 Sign_symptom:T6 T7 Biological_structure 60 77 right iliac fossa T8 Biological_structure 82 102 periumbilical region T9 Diagnostic_procedure 104 114 Ultrasound E3 Diagnostic_procedure:T9 T10 Diagnostic_procedure 121 145 computed tomography scan E4 Diagnostic_procedure:T10 T11 Sign_symptom 157 165 mucocele E5 Sign_symptom:T11 T12 Biological_structure 173 191 vermiform appendix T13 Sign_symptom 213 219 lesion E6 Sign_symptom:T13 T14 Detailed_description 200 212 well defined R1 MODIFY Arg1:T14 Arg2:E6 T15 Biological_structure 235 259 mid zone of the appendix R2 MODIFY Arg1:T4 Arg2:E2 R3 MODIFY Arg1:T5 Arg2:E2 R4 MODIFY Arg1:T7 Arg2:E2 R5 MODIFY Arg1:T8 Arg2:E2 R6 MODIFY Arg1:T12 Arg2:E5 R7 MODIFY Arg1:T15 Arg2:E6 T16 Therapeutic_procedure 283 302 right hemicolectomy E7 Therapeutic_procedure:T16 T17 Diagnostic_procedure 358 375 Gross examination E8 Diagnostic_procedure:T17 T18 Biological_structure 383 400 surgical specimen R8 MODIFY Arg1:T18 Arg2:E8 T19 Lab_value 411 419 enlarged T20 Biological_structure 420 428 appendix R9 MODIFY Arg1:T19 Arg2:T20 T21 Biological_structure 458 475 mucinous material T22 Texture 452 457 thick R10 MODIFY Arg1:T22 Arg2:T21 R11 MODIFY Arg1:T21 Arg2:T20 R12 MODIFY Arg1:T19 Arg2:E8 T23 Coreference 488 494 lesion E9 Coreference:T23 T24 Detailed_description 479 487 distinct R13 MODIFY Arg1:T24 Arg2:E9 T25 Biological_structure 514 530 appendiceal wall T26 Distance 545 551 1.5 cm R14 IDENTICAL Arg1:E9 Arg2:E6 T27 Biological_structure 585 612 mid-portion of the appendix R15 MODIFY Arg1:T25 Arg2:E9 R16 MODIFY Arg1:T26 Arg2:E9 R17 MODIFY Arg1:T27 Arg2:E9 T28 Sign_symptom 639 650 perforation E10 Sign_symptom:T28 A1 POLARITY E10 NEG T29 Sign_symptom 652 665 extravasation E11 Sign_symptom:T29 A2 POLARITY E11 NEG T30 Biological_structure 669 674 mucin T31 Biological_structure 684 706 periappendiceal tissue T32 Disease_disorder 711 733 pseudomyxoma peritonei E12 Disease_disorder:T32 A3 POLARITY E12 NEG T33 Diagnostic_procedure 750 779 Histopathological examination E13 Diagnostic_procedure:T33 T34 Disease_disorder 796 799 GCC E14 Disease_disorder:T34 T35 Disease_disorder 804 807 MCA E15 Disease_disorder:T35 T36 Biological_structure 815 833 vermiform appendix R18 MODIFY Arg1:T36 Arg2:E15 R19 MODIFY Arg1:T36 Arg2:E14 T37 Biological_structure 852 869 appendiceal lumen T38 Sign_symptom 874 881 dilated E16 Sign_symptom:T38 R20 MODIFY Arg1:T37 Arg2:E16 T39 Biological_structure 912 937 columnar epithelial cells T40 Sign_symptom 895 911 mucin-containing E17 Sign_symptom:T40 R21 MODIFY Arg1:E17 Arg2:T39 R22 MODIFY Arg1:T39 Arg2:T37 T41 Sign_symptom 976 992 cytologic atypia E18 Sign_symptom:T41 A4 POLARITY E18 NEG T42 Sign_symptom 1001 1016 mitotic figures E19 Sign_symptom:T42 A5 POLARITY E19 NEG T43 Sign_symptom 1034 1064 Focal papillary configurations E20 Sign_symptom:T43 T44 Biological_structure 1072 1089 lining epithelium R23 MODIFY Arg1:T44 Arg2:E20 T45 Sign_symptom 1100 1131 epithelial pseudostratification E21 Sign_symptom:T45 T46 Severity 1095 1099 mild R24 MODIFY Arg1:T46 Arg2:E21 T47 Sign_symptom 1199 1219 glandular structures E22 Sign_symptom:T47 T48 Biological_structure 1163 1179 appendiceal wall R25 MODIFY Arg1:T48 Arg2:E22 T49 Area 1223 1236 various sizes R26 MODIFY Arg1:T49 Arg2:E22 T50 Shape 1260 1265 nests T51 Shape 1270 1277 tubules R27 MODIFY Arg1:T50 Arg2:E22 R28 MODIFY Arg1:T51 Arg2:E22 T52 Coreference 1285 1305 glandular structures E23 Coreference:T52 R29 IDENTICAL Arg1:E23 Arg2:E22 T53 Biological_structure 1386 1406 neuroendocrine cells T54 Detailed_description 1375 1385 monotonous T55 Area 1347 1374 small to intermediate sized T56 Sign_symptom 1479 1497 cytonuclear atypia E24 Sign_symptom:T56 T57 Severity 1474 1478 mild R30 MODIFY Arg1:T57 Arg2:E24 T58 Detailed_description 1414 1468 small amount of finely granular eosinophilic cytoplasm R31 MODIFY Arg1:T58 Arg2:T53 R32 MODIFY Arg1:T54 Arg2:T53 R33 MODIFY Arg1:T55 Arg2:T53 R34 MODIFY Arg1:T53 Arg2:E22 T59 Biological_structure 1566 1578 goblet cells T60 Detailed_description 1527 1539 mucin-filled T61 Area 1540 1558 intermediate sized T62 Sign_symptom 1628 1649 hyperchromatic nuclei E25 Sign_symptom:T62 T63 Shape 1614 1627 crescent-like R35 MODIFY Arg1:T63 Arg2:E25 T64 Area 1607 1612 small R36 MODIFY Arg1:T64 Arg2:E25 T65 Detailed_description 1586 1606 peripherally located R37 MODIFY Arg1:T65 Arg2:E25 R38 MODIFY Arg1:T61 Arg2:T59 R39 MODIFY Arg1:T60 Arg2:T59 T66 Biological_structure 1666 1674 nucleoli T67 Detailed_description 1655 1665 indistinct R40 MODIFY Arg1:T67 Arg2:T66 R41 MODIFY Arg1:T59 Arg2:E25 R42 MODIFY Arg1:T66 Arg2:E25 T68 Sign_symptom 1759 1774 focally present E26 Sign_symptom:T68 T69 Biological_structure 1730 1753 goblet neoplastic cells T70 Detailed_description 1723 1729 single T71 Detailed_description 1710 1722 infiltrating T72 Texture 1700 1709 Scattered R43 MODIFY Arg1:T70 Arg2:T69 R44 MODIFY Arg1:T71 Arg2:T69 R45 MODIFY Arg1:T72 Arg2:T69 R46 MODIFY Arg1:T69 Arg2:E26 T73 Sign_symptom 1960 1983 lymphovascular invasion E27 Sign_symptom:T73 A6 POLARITY E27 NEG T74 Sign_symptom 2009 2029 intraneural invasion E28 Sign_symptom:T74 T75 Sign_symptom 1994 2004;2021 2029 perineural invasion E29 Sign_symptom:T75 T76 Sign_symptom 1807 1818 tumor nests E30 Sign_symptom:T76 T77 Biological_structure 1874 1891 intestinal crypts T78 Biological_structure 1846 1866 basiglandular region R47 MODIFY Arg1:T78 Arg2:T77 R48 MODIFY Arg1:T77 Arg2:E30 T79 Disease_disorder 1918 1921 MCA E31 Disease_disorder:T79 T80 Detailed_description 1895 1917 close proximity to the R49 MODIFY Arg1:T80 Arg2:E31 R50 MODIFY Arg1:T80 Arg2:E30 T81 Coreference 2047 2052 tumor E32 Coreference:T81 R51 IDENTICAL Arg1:E32 Arg2:E30 R52 IDENTICAL Arg1:E30 Arg2:E22 T82 Biological_structure 2091 2107 appendiceal wall T83 Biological_structure 2069 2083 full thickness R53 MODIFY Arg1:T83 Arg2:T82 R54 MODIFY Arg1:T82 Arg2:E32 T84 Biological_structure 2128 2140 mesoappendix R55 MODIFY Arg1:T84 Arg2:E32 T85 Disease_disorder 2221 2231 malignancy E33 Disease_disorder:T85 A7 POLARITY E33 NEG T86 Biological_structure 2146 2157 lymph nodes T87 Lab_value 2142 2145 Ten R56 MODIFY Arg1:T87 Arg2:T86 R57 MODIFY Arg1:T86 Arg2:E33 T88 Diagnostic_procedure 2163 2188 histologically identified E34 Diagnostic_procedure:T88 R58 MODIFY Arg1:T86 Arg2:E34 T89 Diagnostic_procedure 2233 2254 Immunohistochemically E35 Diagnostic_procedure:T89 T90 Sign_symptom 2271 2282 tumor cells E36 Sign_symptom:T90 T91 Disease_disorder 2290 2293 GCC E37 Disease_disorder:T91 R59 MODIFY Arg1:E36 Arg2:E37 T92 Diagnostic_procedure 2312 2324 chromogranin E38 Diagnostic_procedure:T92 T93 Diagnostic_procedure 2326 2339 synaptophysin E39 Diagnostic_procedure:T93 T94 Diagnostic_procedure 2345 2354 serotonin E40 Diagnostic_procedure:T94 T95 Lab_value 2299 2307 positive R60 MODIFY Arg1:T95 Arg2:E38 R61 MODIFY Arg1:T95 Arg2:E39 R62 MODIFY Arg1:T95 Arg2:E40 T96 Detailed_description 2366 2388 neuroendocrine markers R63 MODIFY Arg1:T96 Arg2:E40 R64 MODIFY Arg1:T96 Arg2:E39 R65 MODIFY Arg1:T96 Arg2:E38 T97 Diagnostic_procedure 2411 2422 cytokeratin E41 Diagnostic_procedure:T97 T98 Diagnostic_procedure 2444 2449 CK19, E42 Diagnostic_procedure:T98 T99 Diagnostic_procedure 2454 2458 CD99 E43 Diagnostic_procedure:T99 T100 Lab_value 2390 2406 Diffuse staining R66 MODIFY Arg1:T100 Arg2:E41 R67 MODIFY Arg1:T100 Arg2:E42 R68 MODIFY Arg1:T100 Arg2:E43 T101 Diagnostic_procedure 2481 2505 Ki67 proliferating index E44 Diagnostic_procedure:T101 T102 Diagnostic_procedure 2599 2603 CK7. E45 Diagnostic_procedure:T102 A8 POLARITY E45 NEG T103 Lab_value 2549 2552 15% T104 Sign_symptom 2560 2571 tumor cells E46 Sign_symptom:T104 R69 MODIFY Arg1:T103 Arg2:E46 T105 Sign_symptom 2515 2531 nuclear staining E47 Sign_symptom:T105 R70 MODIFY Arg1:E47 Arg2:E46 * OVERLAP E1 E2 R71 BEFORE Arg1:E2 Arg2:E3 * OVERLAP E3 E4 E5 E6 R72 BEFORE Arg1:E6 Arg2:E7 R73 BEFORE Arg1:E7 Arg2:E8 * OVERLAP E8 E9 E10 E11 E12 E13 E14 E15 E16 E18 E19 E20 E21 E22 E24 E25 E26 E30 E27 E29 E28 E32 E34 E35 E36 E38 E39 E40 E41 E42 E43 E44 E47 E45 R74 MODIFY Arg1:T30 Arg2:E11 R75 MODIFY Arg1:T31 Arg2:E11