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Melanosis of the appendix: common in the paediatric age group
1Histopathology Department, Royal Alexandra Hospital for Children, Westmead, Sydney, Australia.
Aims:
To investigate the incidence of melanosis of the vermiform appendix in a paediatric population, and look for correlations with season, apoptotic rate and inflammation as possible causes.
Methods And Results:
We examined 300 appendices removed for abdominal pain and incidentally during other procedures over the period January 1996 to March 1999. Melanosis was present in 46% of adequate specimens with an even distribution between sexes and age groups. The two older age groups had a relatively higher incidence of severe involvement compared with the younger age group, although the difference was not statistically significant. We attempted to correlate the presence of melanosis with the season of the year and the peak incidences of paediatric gastrointestinal disease but could find no relationship. No statistically significant correlation was found between apoptotic rate and the presence of melanosis.
Conclusions:
The findings suggest melanosis of the appendix is relatively common. It is probably due to apoptosis associated with increased epithelial cell turnover due to many differing causes including infection, with purgative ingestion probably involved in only a minority of paediatric cases.
Insights
Melanosis of the vermiform appendix is common in children, affecting 46% of specimens. This condition is likely linked to increased cell turnover from various causes, not seasonal factors or apoptotic rates.
Area of Science:
- Gastroenterology
- Pediatric Pathology
Background:
- Melanosis of the vermiform appendix is a poorly understood condition.
- Understanding its prevalence and potential causes in children is important for clinical diagnosis.
Purpose of the Study:
- To determine the incidence of appendiceal melanosis in a pediatric population.
- To explore correlations between melanosis and season, apoptotic rate, and inflammation.
Main Methods:
- Analysis of 300 pediatric appendices collected between 1996 and 1999.
- Examination for melanosis, with assessment of age, sex, season, and gastrointestinal disease incidence.
- Correlation analysis with apoptotic rates.
Main Results:
- Melanosis was observed in 46% of adequate appendiceal specimens.
- No significant correlation was found with season, pediatric gastrointestinal disease peaks, or apoptotic rate.
- Older children showed a trend towards more severe melanosis, but this was not statistically significant.
Conclusions:
- Appendiceal melanosis is a common finding in pediatric patients.
- The condition is likely associated with increased epithelial cell turnover due to diverse causes, including infection.
- Purgative ingestion is implicated in only a small fraction of pediatric cases.