Abstract:
To investigate the prevalence and implications
of unusual histopathological findings in appendectomy
specimens from patients with suspected acute appendicitis.
METHODS: The demographic and histopathological
data of 1621 patients (≥ 16 years-old) who underwent
appendectomy to treat an initial diagnosis of acute appendicitis
between January 1999 and November 2011
were retrospectively assessed. Microscopic findings
were used to classify the patients under six categories:
appendix vermiformis, phlegmonous appendicitis, gangrenous
appendicitis, perforated appendicitis, supurative
appendicitis, and unusual histopathologic findings.
The demographic and clinicopathologic characteristics
of patients with unusual histopathologic findings were
evaluated in detail, and re-analysis of archived resected
appendix specimens was carried out.
RESULTS: A total of 912 males and 709 females, from16 to 94 years old, were included in the study and
comprised 789 cases of suppurative appendicitis, 370
cases of appendix vermiformis, 243 cases of perforated
gangrenous appendicitis, 53 cases of flegmaneous appendicitis,
32 cases of gangrenous appendicitis, and
134 (8.3%) cases of unusual histopathological findings.
The unusual histopathological findings included fibrous
obliteration (n = 62), enterobius vermicularis (n = 31),
eosinophilic infiltration (n = 10), mucinous cystadenoma
(n = 8), carcinoid tumor (n = 6), granulomatous
inflammation (n = 5), adenocarcinoma (n = 4; one of
them mucinous), and mucocele (n = 3), adenomatous
polyp (n = 1), taenia sup (n = 1), ascaris lumbricoides (n
= 1), appendiceal diverticula (n = 1), and B cell nonhodgkin
lymphoma (n = 1). None of the 11 patients
with subsequent diagnosis of tumor were suspected of
cancer prior to the appendectomy.
CONCLUSION: Even when the macroscopic appearance
of appendectomy specimens is normal, histopathological
assessment will allow early diagnosis of many
unusual diseases.