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.

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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