Zarbaliyev Elbrus, Okumus Mustafa, Hacisalihoglu Payam
Department of General Surgery, Istanbul Yeni Yuzyil University, Gaziosmanpasa Hospital, Istanbul, Turkiye.
Department of Pediatric Surgery, Istanbul Yeni Yuzyil University, Gaziosmanpasa Hospital, Istanbul, Turkiye.
North Clin Istanb. 2024 Nov 19;11(6):579-582. doi: 10.14744/nci.2022.78477. eCollection 2024.
Xanthogranulomatous inflammation is a rare chronic inflammatory reaction. Appendiceal involvement in the pediatric age group is extremely rare. We present a case of xanthogranulomatous appendicitis (XGA) that was detected incidentally during the excision of a residual intraabdominal mass in an 8-year-old male patient who was treated for Burkitt lymphoma. An 8-year-old male patient who had been diagnosed with Burkitt lymphoma underwent abdominal computerized tomography for evaluation after chemotherapy. An approximately 2.5 cm mass in the right lower quadrant of the abdomen was detected, and laparoscopic excision of the mass was planned. During the operation, it was noticed that the appendix (adjacent to the mass) was golden yellow in color and abnormal in appearance, so a synchronous appendectomy was performed. The pathology result of the mass was compatible with Burkitt lymphoma. Microscopic examination of the appendix revealed that the columnar surface epithelium had eroded and been replaced by fibrin and cell debris. Inflammatory cell infiltration rich in foamy histiocytes as well as lymphocytes and sparse neutrophils that form destructive aggregates was observed in all appendiceal layers. The final diagnosis of the appendectomy specimen was compatible with XGA. In very few XGA cases, the appendix is described as bright yellow or golden yellow. The diagnosis is usually made by the pathological examination after surgery. Though the diagnosis was made postoperatively in our case, there is now, for the first time in the literature, a view of the golden yellow color of XGA taken from an intraoperative video clip.
黄色肉芽肿性炎症是一种罕见的慢性炎症反应。小儿阑尾受累极为罕见。我们报告一例黄色肉芽肿性阑尾炎（XGA），该病例是在一名接受伯基特淋巴瘤治疗的8岁男性患者切除腹腔残余肿块时偶然发现的。一名被诊断为伯基特淋巴瘤的8岁男性患者在化疗后接受腹部计算机断层扫描以进行评估。发现腹部右下腹有一个约2.5厘米的肿块，并计划通过腹腔镜切除该肿块。手术过程中，发现阑尾（与肿块相邻）颜色呈金黄色且外观异常，因此同步进行了阑尾切除术。肿块的病理结果与伯基特淋巴瘤相符。对阑尾的显微镜检查显示，柱状表面上皮已糜烂，被纤维蛋白和细胞碎片取代。在阑尾各层均观察到富含泡沫状组织细胞以及淋巴细胞和稀疏中性粒细胞的炎性细胞浸润，形成破坏性聚集。阑尾切除标本的最终诊断与XGA相符。在极少数XGA病例中，阑尾被描述为亮黄色或金黄色。诊断通常在手术后通过病理检查做出。尽管我们的病例是在术后做出诊断的，但现在文献中首次有了从术中视频片段中看到的XGA金黄色外观的记录。
