Department of Diagnostic Radiology, Sengkang General Hospital Singapore, Singapore.
Department of Pathology, Sengkang General Hospital Singapore, Singapore.
J Radiol Case Rep. 2020 Nov 30;14(11):26-38. doi: 10.3941/jrcr.v14i11.4081. eCollection 2020 Nov.
Occasionally, radiologically diagnosed acute appendicitis is found to harbour underlying appendiceal neoplasm on post-surgical histopathology. Conversely, a situation in which radiologically, the appendix demonstrates features consistent with an underlying tumour but post-operative pathology finds no evidence of neoplastic change is rare. We describe a case of a 50-year-old man who presented with a markedly dilated "mass-like" appendix with minimal inflammatory changes on a computed tomography scan. Radiological findings were suspicious for an appendiceal neoplasm/mucocele (i.e. low-grade mucinous neoplasm). However, the post-surgical histopathological diagnosis did not concur with the radiological diagnosis and instead demonstrated findings compatible with acute appendicitis without neoplastic change. In this case report we provide a histopathological correlation and an explanation as to how this may have happened with the hope of helping radiologists avoid this pitfall in the future.
偶尔，在术后组织病理学检查中发现放射学诊断为急性阑尾炎的病例实际上存在阑尾内肿瘤。相反，在放射学上阑尾表现出与潜在肿瘤一致的特征，但术后病理检查未发现肿瘤变化的情况则较为罕见。我们描述了一例 50 岁男性病例，其 CT 扫描显示阑尾显著扩张呈“肿块样”，仅有轻微炎症改变。放射学检查结果提示阑尾肿瘤/黏液囊肿（即低度黏液性肿瘤）可能性大。然而，术后组织病理学诊断与放射学诊断不一致，而是显示出急性阑尾炎的表现，没有肿瘤性改变。在本病例报告中，我们提供了组织病理学相关性，并解释了这种情况发生的原因，希望能帮助放射科医生在未来避免这一陷阱。
