Unusual histopathologies of the appendix

Area of Science:

• Pathology
• Gastroenterology
• Surgical Emergencies

Background:

• Appendicitis is a common surgical emergency often caused by luminal occlusion.
• Unusual etiologies include infections, parasites, tuberculosis, and neoplasms, necessitating specific management.
• Recognizing these rare causes is vital for appropriate patient care.

Purpose of the Study:

• To determine the incidence and types of unusual histopathology in appendicitis.
• To analyze appendectomy specimens for non-typical findings.

Main Methods:

• Retrospective review of 2,244 appendectomy histopathology reports from three Johannesburg academic hospitals (January 2012-December 2014).
• Specimens were examined by pathologists from the National Health Laboratory Services (NHLS).

Main Results:

• Unusual pathology was identified in 5.3% (119/2,244) of appendectomy specimens.
• The most frequent unusual causes were parasites (37%), predominantly schistosomiasis (24.3%), followed by neoplasms (20%) and fibrous obliteration (14.2%).
• The median patient age was 25.6 years, with 61.9% males and 38.1% females.

Conclusions:

• All appendectomy specimens require histopathological examination for accurate diagnosis.
• Post-operative review of results is essential to identify unusual findings that may require further specific treatment.