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Granulomatous appendicitis presenting as right lower quadrant pain: CT findings
R Zissin1, G Gayer, J Bernheim
1Department of Diagnostic Imaging, Sapir Medical Center, Kfar Saba 44281, Israel.
Abdominal Imaging
|February 20, 2003
Summary
Computed tomographic (CT) findings of granulomatous appendicitis are rare. CT may reveal an enlarged appendix and surrounding inflammation, suggesting this condition or other serious diagnoses.
Area of Science:
- Radiology
- Pathology
- Gastroenterology
Background:
- Granulomatous appendicitis is a rare condition.
- Computed tomography (CT) is a key imaging modality for diagnosing abdominal conditions.
Purpose of the Study:
- To describe the computed tomographic (CT) findings in patients with granulomatous appendicitis.
- To increase awareness of this rare entity among radiologists.
Main Methods:
- Retrospective review of CT findings in four patients with histopathologically confirmed granulomatous appendicitis.
- Analysis focused on appendiceal abnormalities and associated findings.
Main Results:
- Granulomatous appendicitis was found in 0.9% of patients undergoing appendectomy for suspected acute appendicitis.
- CT revealed enlarged appendices (up to 4.5 cm diameter) with thickened walls, periappendiceal inflammatory masses, enlarged mesenteric lymph nodes, and fat stranding.
- Histopathology confirmed numerous granulomas within the inflamed appendix.
Conclusions:
- Radiologists should consider granulomatous appendicitis in the differential diagnosis for patients with suspected acute appendicitis presenting with CT findings of an exceptionally large appendix and periappendiceal inflammation.
- These CT findings can also be indicative of appendiceal carcinoma or lymphoma.