Department of Surgery, Liver Transplant Institute, Inonu University Faculty of Medicine, 44280 Malatya, Turkey.
World J Gastroenterol. 2013 Jul 7;19(25):4015-22. doi: 10.3748/wjg.v19.i25.4015.
To investigate the prevalence and implications of unusual histopathological findings in appendectomy specimens from patients with suspected acute appendicitis.
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.
A total of 912 males and 709 females, from 16 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 non-hodgkin lymphoma (n = 1). None of the 11 patients with subsequent diagnosis of tumor were suspected of cancer prior to the appendectomy.
Even when the macroscopic appearance of appendectomy specimens is normal, histopathological assessment will allow early diagnosis of many unusual diseases.
探讨在疑似急性阑尾炎患者的阑尾切除标本中不常见的组织病理学发现的流行情况及其意义。
回顾性评估了 1999 年 1 月至 2011 年 11 月期间因疑似急性阑尾炎行阑尾切除术的 1621 例（≥ 16 岁）患者的人口统计学和组织病理学数据。根据显微镜下的发现，将患者分为六类：阑尾蚓突、蜂窝织炎性阑尾炎、坏疽性阑尾炎、穿孔性阑尾炎、化脓性阑尾炎和不常见的组织病理学发现。详细评估了具有不常见组织病理学发现的患者的人口统计学和临床病理特征，并对存档的切除阑尾标本进行了重新分析。
共有 912 名男性和 709 名女性，年龄 16 至 94 岁，包括 789 例化脓性阑尾炎、370 例阑尾蚓突、243 例穿孔坏疽性阑尾炎、53 例蜂窝织炎性阑尾炎、32 例坏疽性阑尾炎和 134 例（8.3%）不常见的组织病理学发现。不常见的组织病理学发现包括纤维性闭塞（n = 62）、蛲虫（n = 31）、嗜酸性粒细胞浸润（n = 10）、黏液囊腺瘤（n = 8）、类癌肿瘤（n = 6）、肉芽肿性炎症（n = 5）、腺癌（n = 4；其中 1 例为黏液性）、黏液囊肿（n = 3）、腺瘤性息肉（n = 1）、绦虫（n = 1）、蛔虫（n = 1）、阑尾憩室（n = 1）和 B 细胞非霍奇金淋巴瘤（n = 1）。在随后诊断为肿瘤的 11 例患者中，均未在阑尾切除术前怀疑癌症。
即使阑尾切除标本的大体外观正常，组织病理学评估也能早期诊断许多不常见的疾病。
