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Incidental Findings in Routine Histopathological Examination of Appendectomy Specimens; Retrospective Analysis of
Oğuzhan Dincel1, Mustafa Göksu1, Bilge Aydın Türk2
11Department of General Surgery, Faculty of Medicine, Adiyaman University, Yeni mah. 26294 sk. Elif Kent Sitesi B Blok No:2, Adiyaman, Turkey.
Abstract:
Diseases and tumors of the appendix vermiformis are very rare, except for acute appendicitis. This study aimed to examine rare findings in the histopathologic examinations of specimens of patients undergoing appendectomy due to the diagnosis of acute appendicitis. The files of 1970 patients undergoing appendectomy due to the diagnosis of acute appendicitis between March 2012 and March 2016 were retrospectively investigated. Rare findings were found in 59 (3 %) patients, and these were evaluated in detail. Patients' age, gender, pathology reports, and postoperation follow-ups were recorded. The rare histopathological findings of 59 patients were examined. Of these, 31 were female (52.5 %) and 28 were male (47.5 %). The average age was 33.1 ± 18.2 years. The unusual findings were as follows: 16 fibrous obliteration, 11 Enterobius vermicularis, 2 schistosomiasis, 3 appendiceal neuroma, 2 granulomatous appendicitis, 1 Crohn's disease, 3 chronic appendicitis, 1 endometriosis, 2 hyperplastic polyps, 9 mucinous cystadenoma (+mucocele), 8 carcinoid tumors, and 1 lymphoma. All of the malignant tumors were localized in the distal end of the appendix, and all of the patients were treated with appendectomy. Patients with parasitic diseases also underwent anthelmintic treatment, while chemotherapy was administered to the patient with lymphoma. All of the patients diagnosed with malignancy were alive reported no problems at their follow-ups. Although all of the appendectomy samples were normal macroscopically, data from this study suggest that all specimens should be sent for routine investigation.
Insights
Rare appendiceal findings, including tumors and parasitic infections, occur in 3% of appendectomy specimens. Routine histopathological examination of all appendix samples is recommended, even if macroscopic findings appear normal.
Area of Science:
- Gastroenterology
- Pathology
- Surgical Oncology
Background:
- Diseases and tumors of the appendix vermiformis are uncommon, with acute appendicitis being the most frequent diagnosis.
- Histopathological examination of appendectomy specimens can reveal rare conditions not apparent macroscopically.
Purpose of the Study:
- To investigate the incidence and types of rare histopathological findings in patients undergoing appendectomy for acute appendicitis.
- To emphasize the importance of routine histopathological analysis of all appendectomy specimens.
Main Methods:
- Retrospective analysis of 1970 appendectomy cases performed between March 2012 and March 2016.
- Detailed evaluation of rare histopathological findings, including patient demographics, pathology reports, and follow-up data.
Main Results:
- Rare findings were identified in 59 (3%) patients.
- The spectrum of rare findings included fibrous obliteration, parasitic infections (Enterobius vermicularis, schistosomiasis), appendiceal neuroma, granulomatous appendicitis, Crohn's disease, chronic appendicitis, endometriosis, hyperplastic polyps, mucinous cystadenoma, carcinoid tumors, and lymphoma.
- Malignant tumors were localized in the distal appendix; all patients with malignancy survived post-appendectomy.
Conclusions:
- Routine histopathological examination of all appendectomy specimens is crucial for identifying rare diseases and tumors, even when macroscopic findings are normal.
- Early detection and appropriate treatment of rare appendiceal pathologies improve patient outcomes.
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