Müller G, Dargent J L, Duwel V, D'Olne D, Vanvuchelen J, Haot J, Hustin J
Department of Pathology, Jules Bordet Institute, Free University of Brussels, Belgium.
J Cancer Res Clin Oncol. 1997;123(10):560-4. doi: 10.1007/s004320050105.
Leukaemic and lymphomatous infiltration of the appendix is rare and even rarer is acute appendicitis as the initial manifestation. From our routine biopsy material we collected four cases of haematological malignancies presenting as acute appendicitis or acute abdomen, caused or accompanied by tumoral infiltration of the appendix. Appendicitis was the initial manifestation that allowed diagnosis of the underlying disease. The clinical histories and histological examinations of the appendices and of one autopsy are described. We report the first detailed description of acute myeloid leukaemia involving the appendix, and three cases of lymphomatous infiltration of the appendix presenting with appendicitis, and give an overview of the literature. In these days of budgetary cuts in national health services, where one may be tempted not to have seemingly commonplace cases of appendicitis histologically verified, our cases emphasize that careful histopathological examination of all appendectomy specimens should be mandatory. Despite the fact that leukaemia and lymphoma of the appendix are rare, our cases illustrate that these must be included in the differential diagnosis of acute appendicitis and that physicians and surgeons have to be aware of these conditions.
白血病和淋巴瘤浸润阑尾的情况罕见，而以急性阑尾炎作为初始表现的情况则更为罕见。从我们的常规活检材料中，我们收集到4例血液系统恶性肿瘤病例，这些病例表现为急性阑尾炎或急腹症，由阑尾肿瘤浸润引起或伴有阑尾肿瘤浸润。阑尾炎是得以诊断潜在疾病的初始表现。本文描述了这些阑尾的临床病史以及组织学检查情况，并介绍了一例尸检情况。我们报告了首例关于累及阑尾的急性髓系白血病的详细描述，以及3例表现为阑尾炎的阑尾淋巴瘤浸润病例，并对相关文献进行了综述。在如今国家医疗服务预算削减的情况下，人们可能会倾向于不对看似常见的阑尾炎病例进行组织学验证，但我们的病例强调，对所有阑尾切除标本进行仔细的组织病理学检查应成为强制性要求。尽管阑尾白血病和淋巴瘤很少见，但我们的病例表明，在急性阑尾炎的鉴别诊断中必须考虑到这些疾病，医生和外科医生必须了解这些情况。
