Unusual Histopathological Findings in Appendectomy Specimens: A Retrospective Analysis of 2047 Cases

2018 ◽  
Vol 27 (2) ◽  
pp. 142-146 ◽  
Author(s):  
Nurcan Unver ◽  
Ganime Coban ◽  
Dilek Sema Arıcı ◽  
Nur Buyukpınarbasılı ◽  
Zuhal Gucin ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Histopathological Examination ◽  
Demographic Data ◽  
Granulomatous Inflammation ◽  
Mesenteric Cyst ◽  
Cystic Neoplasm ◽  
Low Grade ◽  
Clinicopathologic Characteristics ◽  
Macroscopic Appearance ◽  
Histopathologic Findings

Background. In this study, we retrospectively evaluated cases of patients who had undergone appendectomy in our hospital and aimed to present the efficiency of diagnostic tests and demographic data of cases. Pathological reports were analyzed for the following parameters: age, gender, and pathological diagnosis. In addition, the demographic and clinicopathologic characteristics of patients with unusual histopathologic findings were evaluated in detail, and reanalysis of archived resected appendix specimens was carried out. Methods. Files of 2047 patients (1329 males, 718 females, sex ratio: 1.85, age range: 1-87 years, mean age: 26, 50 years), who had been operated with a diagnosis of acute appendicitis in the emergency department of Bezmialem Vakıf University Medical Faculty from November 2011 to June 2014, were retrospectively evaluated. Results. Cases were separated into 2 groups. Cases with histopathologic examination reported as acute appendicitis constituted group 1 (n = 2013, 98.34%), and cases with pathologic findings other than acute appendicitis constituted group 2 (n = 34, 1.66%). The second group consisted of 8 low-grade mucinous neoplasms, 7 mucoceles, 6 carcinoid, 5 granulomatous inflammation, 4 intraluminal Enterobius vermicularis, 1 endometriosis externa, 1 adenocarcinoma infiltrated to serosa, 1 mesenteric cyst, and 1 low-grade adenocarcinoma formed in mucinous cystic neoplasm background. Conclusion. Acute appendicitis is the most common emergency surgical condition. Although most of the resected appendectomy specimens showed typical histopathologic findings, some (1.66%) showed unusual histopathologic findings. Even if the macroscopic appearance of the specimen is normal or acute appendicitis, we suggest routine histopathological examination.

scholarly journals Petroleum jelly-induced penile paraffinoma with inguinal

2013 ◽  
Vol 6 (4) ◽  
pp. 137 ◽  
Author(s):  
István Sejben ◽  
András Rácz ◽  
Mihály Svébis ◽  
Márta Patyi ◽  
Gábor Cserni
Keyword(s):  
Inguinal Hernia ◽  
Histopathological Examination ◽  
Granulomatous Inflammation ◽  
Mineral Oil ◽  
Petroleum Jelly ◽  
Diagnostic Dilemma ◽  
Incarcerated Inguinal Hernia ◽  
Patient’S History ◽  
Histopathologic Findings ◽  
Clinical Characteristic

Chronic granulomatous inflammation may develop after injectingforeign oily substances into the penis. The disorder affects mainlythe site of administration, but regional lymphadenopathy or evensystemic disease can occur. We present a 39-year-old man withpetroleum jelly-induced penile lesion and unilateral inguinal lymphadenitis mimicking incarcerated inguinal hernia. At hernioplasty no hernial sac was found, but enlarged lymph nodes suspicious for malignancy were identified. The histopathologic findings of these nodes were consistent with mineral oil granuloma. Paraffinoma of the male genitalia can cause various clinical features posing a differential diagnostic dilemma. Regional lymphadenitis may be the main clinical characteristic. Patient’s history, physical and histopathological examination are required to establish the diagnosis.

scholarly journals Laparoscopic Resection of an Epithelial Cyst in an Intrapancreatic Accessory Spleen

2017 ◽  
Vol 11 (3) ◽  
pp. 803-811
Author(s):  
Kazuhiro Suzumura ◽  
Etsuro Hatano ◽  
Toshihiro Okada ◽  
Yasukane Asano ◽  
Naoki Uyama ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Histopathological Examination ◽  
Accessory Spleen ◽  
Cystic Tumor ◽  
Cystic Neoplasm ◽  
Low Grade ◽  
Epithelial Cyst ◽  
Intrapancreatic Accessory Spleen ◽  
Pancreatic Tail ◽  
Splenic Parenchyma

An epithelial cyst in an intrapancreatic accessory spleen (ECIAS) is rare. We herein report a case of a patient with ECIAS who underwent laparoscopic surgery. A 57-year-old woman was referred to our hospital because of a pancreatic tail tumor. She was asymptomatic, and a physical examination revealed no remarkable abnormalities. The levels of the tumor marker carbohydrate antigen 19-9 (CA19-9) and s-pancreas-1 antigen (SPan-1) were elevated. Ultrasonography showed a well-defined homogeneous cystic tumor. Computed tomography showed a well-demarcated cystic tumor in the pancreatic tail. Magnetic resonance imaging showed that the cystic tumor exhibited low intensity on T1-weighted images and high intensity on T2-weighted images. The cystic tumor was diagnosed as mucinous cystic neoplasm preoperatively. The patient underwent laparoscopic spleen-preserving distal pancreatectomy. A histopathological examination revealed the cyst wall to be lined by stratified squamous epithelium within splenic parenchyma, and the ultimate diagnosis was ECIAS. The postoperative course was uneventful, and the patient was discharged on postoperative day 12. ECIAS is very difficult to diagnose preoperatively. Laparoscopic surgery is a safe and minimally invasive procedure for patients with difficult-to-diagnose pancreatic tail tumor suspected of having low-grade malignancy.

Acute Appendicitis Associated With Schistosoma Species

2019 ◽  
Vol 152 (Supplement_1) ◽  
pp. S60-S61
Author(s):  
Jesus Rico Castillo ◽  
Diana Alame ◽  
Madalina Tuluc ◽  
Michelle Nagurney ◽  
Noha Ghusson
Keyword(s):  
Acute Appendicitis ◽  
Histopathological Examination ◽  
Granulomatous Inflammation ◽  
Public Health Problem ◽  
The United States ◽  
Sub Saharan Africa ◽  
Lower Quadrant ◽  
Tropical Regions ◽  
Host Immune Responses ◽  
Sub Saharan

Abstract Objectives Schistosomiasis is a public health problem in tropical regions of the world, highly endemic in sub-Saharan Africa but uncommon in the United States. It is considered second only to malaria as the most devastating human parasitic diseases, and it is mainly classified as urinary or intestinal. Here we report a rare case of acute appendicitis associated with Schistosoma spp. Case Presentation A 28-year-old male presented to our institution in October 2018 with a 2-day history of periumbilical and right lower quadrant abdominal pain associated with nausea, vomiting, fever, and chills. CT scan of the abdomen in the emergency department showed hyperenhancement of the appendix, with an increased diameter of 10 mm and infiltration of the adjacent fat, compatible with appendicitis. The patient was administered intravenous piperacillin-tazobactam and underwent an uncomplicated laparoscopic appendectomy. Histopathological examination of the appendectomy specimen reveals neutrophilic infiltrate of the wall consistent with acute appendicitis, with granulomatous inflammation surrounding parasitic eggs measuring 60 by 37 μm morphologically consistent with Schistosoma spp. within the wall. Additionally, Ziehl-Neelsen stained negative. Significant travel history included a trip to Lake Malawi approximately 9 years prior to this presentation where he frequently swam in freshwater lakes. He does not recall developing an acute illness associated with this travel. Discussion Chronic schistosomiasis is the result of host immune responses to schistosome eggs that become lodged in the capillaries or organs and cause granulomatous reactions. Chronic inflammation can lead to bowel wall ulceration, hyperplasia, and polyposis and, with massive infection, to periportal liver fibrosis, dysuria, and hematuria. Small bowel involvement is very unusual and only rare cases of appendicitis have been reported worldwide. Additionally, Ziehl-Neelsen stained negative favoring other Schistosoma species instead of S mansoni, S intercalatum, or S japonicum. Fortunately, the patient underwent surgery, received praziquantel, and achieved full recovery.

scholarly journals Diagnosis and Treatment of Mucinous Appendiceal Neoplasm Presented as Acute Appendicitis

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Ioannis Kehagias ◽  
Apollon Zygomalas ◽  
Georgios Markopoulos ◽  
Thanasis Papandreou ◽  
Pantelis Kraniotis
Keyword(s):  
Acute Appendicitis ◽  
Acute Abdomen ◽  
Histopathological Examination ◽  
Fluid Collection ◽  
Laparoscopic Approach ◽  
Low Grade ◽  
Emergency Setting ◽  
Cytologic Examination ◽  
Appendiceal Neoplasm ◽  
Appendiceal Mucocele

Appendiceal mucocele is a rare cause of acute abdomen. Mucinous appendiceal neoplasms represent 0.2–0.7% of all appendix specimens. The aim of this study is to report a case of a mucinous appendiceal neoplasm presented as acute appendicitis, discussing the clinical and surgical approach in the emergency setting. A 72-year-old female patient was admitted to the emergency department with a clinical examination indicative of acute abdomen. The patient underwent abdominal computed tomography scan which revealed a cystic lesion in the right iliac fossa measuring 8.3 × 5.2 × 4.1 cm, with calcified walls, and a mean density indicative of high protein content. The patient was taken to the operating room and a right hemicolectomy was performed. The postoperative course was unremarkable. The histopathological examination revealed a low-grade mucinous appendiceal neoplasm with negative regional lymph nodes. Ultrasound and CT are useful in diagnosing appendiceal mucocele and synchronous cancers in the emergency setting. The initial operation should include appendectomy and resection of the appendicular mesenteric fat along with any fluid collection for cytologic examination. During urgent appendectomy it is important to consider every mucocele as malignant in order to avoid iatrogenic perforation causing pseudomyxoma peritonei. Although laparotomy is recommended, the laparoscopic approach is not contraindicated.

scholarly journals Adenocarcinoma of the appendix mimicking complicated appendicitis in the elderly: A report of two cases

2018 ◽  
Vol 71 (11-12) ◽  
pp. 405-408
Author(s):  
Mirjana Cuk ◽  
Radoslav Gajanin ◽  
Slavisa Djuricic ◽  
Veljko Maric ◽  
Radmil Maric ◽  
...  
Keyword(s):  
Adjuvant Chemotherapy ◽  
Acute Appendicitis ◽  
Histopathological Examination ◽  
Right Hemicolectomy ◽  
Complicated Appendicitis ◽  
Histopathological Analysis ◽  
Low Grade ◽  
Recurrent Tumor ◽  
Appendiceal Adenocarcinoma ◽  
Complicated Acute Appendicitis

Introduction. Primary appendiceal adenocarcinoma is a very rare malignancy which accounts for 0.1% of all appendectomy specimens. In both patients presented in this paper, appendectomy was performed due to suspected acute complicated appendicitis. Case Reports. The first patient, a 77-year-old man, presented with a low grade colonic-type pT3 adenocarcinoma of the appendix, diagnosed by histopathological examination of the resected appendix delivered in a fixative. A month after appendectomy, the patient underwent right hemicolectomy of a tumor at the edge of the resection. Due to a cardiovascular disease, adjuvant chemotherapy was not indicated. The second patient, a 74-year-old female, presented with a low grade mucinous adenocarcinoma of the appendix with subserous infiltration, diagnosed by histopathological analysis of the resected appendix. Eight months after appendectomy, the patient developed a recurrent tumor in the cecal area. After radical surgical excision of the recurrent tumor, the patient received adjuvant chemotherapy. Both patients had a 5-year survival without relapse. Conclusion. Preoperative diagnosis of appendiceal adenocarcinoma is a challenge due to overlapping symptoms of complicated acute appendicitis. Our results suggest that in elderly patients with symptoms of complicated acute appendicitis, appendectomy should be done with intraoperative histopathological frozen section consultation. In advanced stages of adenocarcinoma, right hemicolectomy is a better choice than appendectomy.

scholarly journals Prevalence of parasitic infections in surgically removed appendices: parasitological and histopathological studies

2018 ◽  
Vol 55 (1) ◽  
pp. 33-44 ◽  
Author(s):  
A. S. Amer ◽  
A. E. Saad ◽  
S. N. Antonios ◽  
E. A. Hasby
Keyword(s):  
Acute Appendicitis ◽  
Histopathological Examination ◽  
Intestinal Parasites ◽  
Demographic Data ◽  
Clinical History ◽  
Cross Sectional Study ◽  
Lymphoid Hyperplasia ◽  
Stool Examination ◽  
Parasitic Infections ◽  
Cross Sectional

Summary Intestinal parasites may cause symptoms similar to acute appendicitis. Moreover, the diagnosis of parasitic infections is only done by post-operative histopathological examination of the appendices. Therefore, our aims are to assess the prevalence of intestinal parasitic infections among patients who were be appendectomized at Tanta Hospitals, Egypt and to investigate the possible association between these parasitic infections and appendicitis. To achieve these objectives, we performed a cross-sectional study including 65 patients chosen randomly who had undergone appendectomy over a period of one year from Oct 2015 to Oct 2016. Demographic data were retrieved. Complete blood picture was done. Moreover, appendiceal faecolith were examined macroscopically then by direct smear examination, formol-ether concentration technique, modified Ziehl-Nelseen stain and rapid immunochromatographic test. Histopathological examination of resected appendices was done. We found that parasitic infections were detected in 24.6 % of examined cases. Most of parasitic infections were prevalent in patients belonging to the school age group. Different parasitic infections were detected in the faecolith specimens. Moreover, Enterobious vermicularis adult female and Schistosoma mansoni granuloma were detected in histopathological sections. Also, a spectrum of pathological changes in the appendices was found ranging from lymphoid hyperplasia to acute inflammation with peritonitis. In conclusion, intestinal parasites may cause clinical picture similar to that of acute appendicitis. Therefore, careful attention to clinical history, stool examination and high eosinophilia may aid diagnosis and avoid unnecessary appendectomy. Moreover, the presence of different parasitic stages in the narrow lumen of the appendix may have a role in the development of appendicitis and this needs further studies.

scholarly journals Placental Complement Activation in Fetal and Neonatal Alloimmune Thrombocytopenia: An Observational Study

2021 ◽  
Vol 22 (13) ◽  
pp. 6763
Author(s):  
Thijs W. de Vos ◽  
Dian Winkelhorst ◽  
Hans J. Baelde ◽  
Kyra L. Dijkstra ◽  
Rianne D. M. van Bergen ◽  
...  
Keyword(s):  
Complement Activation ◽  
Histopathological Examination ◽  
Hla Class I ◽  
Unknown Etiology ◽  
Low Grade ◽  
Classical Pathway ◽  
Newly Diagnosed ◽  
Activation Markers ◽  
Amsterdam Criteria ◽  
Alloimmune Thrombocytopenia

Fetal and neonatal alloimmune thrombocytopenia (FNAIT) is a disease that causes thrombocytopenia and a risk of bleeding in the (unborn) child that result from maternal alloantibodies directed against fetal, paternally inherited, human platelet antigens (HPA). It is hypothesized that these alloantibodies can also bind to the placenta, causing placental damage. This study aims to explore signs of antibody-mediated placental damage in FNAIT. We performed a retrospective study that included pregnant women, their newborns, and placentas. It comprised 23 FNAIT cases, of which nine were newly diagnosed (14 samples) and 14 were antenatally treated with intravenous immune globulins (IVIg) (21 samples), and 20 controls, of which 10 had anti-HLA-class I antibodies. Clinical information was collected from medical records. Placental samples were stained for complement activation markers (C1q, C4d, SC5b-9, and mannose-binding lectin) using immunohistochemistry. Histopathology was examined according to the Amsterdam criteria. A higher degree of C4d deposition was present in the newly diagnosed FNAIT cases (10/14 samples), as compared to the IVIg-treated FNAIT cases (2/21 samples, p = 0.002) and anti-HLA-negative controls (3/20 samples, p = 0.006). A histopathological examination showed delayed maturation in four (44%) placentas in the newly diagnosed FNAIT cases, five (36%) in the IVIg-treated FNAIT cases, and one in the controls (NS). C4d deposition at the syncytiotrophoblast was present in combination with low-grade villitis of unknown etiology in three newly diagnosed FNAIT cases that were born SGA. We conclude that a higher degree of classical pathway-induced complement activation is present in placentas from pregnancies with untreated FNAIT. This may affect placental function and fetal growth.

Dermal fibrosarcoma in a Cashmere goat

2019 ◽  
Vol 47 (03) ◽  
pp. 192-195
Author(s):  
Julia Schoiswohl ◽  
Bianca Lambacher ◽  
Andrea Klang ◽  
Reinhild Krametter-Frötscher
Keyword(s):  
Differential Diagnosis ◽  
Case Report ◽  
Connective Tissue ◽  
Malignant Tumors ◽  
Histopathological Examination ◽  
Low Grade ◽  
Cashmere Goat ◽  
Short Lifespan ◽  
Production Processes

AbstractFibrosarcomas are malignant tumors of the connective tissue, which are characterized by proliferation of fibroblasts. Most of these tumors are localized subcutaneously and cause different symptoms depending on their location. The case report describes a dermal tumor on the outside of the pinna in a 7-year-old female Cashmere goat. The tumor was surgically removed and histopathological examination revealed a low grade fibrosarcoma. Although tumors are rare in ruminants because of the animals’ short lifespan (age of slaughtering in most cases < 24 months) in modern production processes, they should be considered as a differential diagnosis.

scholarly journals Low-grade serous epithelial ovarian cancer: a comprehensive review and update for radiologists

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Sofia Amante ◽  
Filipa Santos ◽  
Teresa Margarida Cunha
Keyword(s):  
Ovarian Cancer ◽  
Serous Carcinoma ◽  
Low Grade ◽  
Resonance Imaging ◽  
Clinicopathologic Characteristics ◽  
Borderline Tumour ◽  
Molecular Features ◽  
Serous Epithelial Ovarian Cancer ◽  
The Difference

AbstractLow-grade serous carcinoma (LGSC) is an infrequent subtype of ovarian cancer, corresponding to 5% of epithelial neoplasms. This subtype of ovarian carcinoma characteristically has molecular features, pathogenesis, clinical behaviour, sensitivity to chemotherapy, and prognosis distinct to high-grade serous carcinoma (HGSC). Knowing the difference between LGSC and other ovarian serous tumours is vital to guide clinical management, which currently is only possible histologically. However, imaging can provide several clues that allow differentiating LGSC from other tumours and enable precise staging and follow-up of ovarian cancer treatment. Characteristically, LGSC appears as mixed lesions with variable papillary projections and solid components, usually in different proportions from those detected in serous borderline tumour and HGSC. Calcified extracellular bodies, known as psammoma bodies, are also a common feature of LGSC, frequently detectable within lymphadenopathies and metastases associated with this type of tumour. In addition, the characterisation of magnetic resonance imaging enhancement also plays an essential role in calculating the probability of malignancy of these lesions. As such, in this review, we discuss and update the distinct radiological modalities features and the clinicopathologic characteristics of LGSC to allow radiologists to be familiarised with them and to narrow the differential diagnosis when facing this type of tumour.

Rheumatic Pneumonia: The Need for a New Approach

PEDIATRICS ◽  
1975 ◽  
Vol 56 (6) ◽  
pp. 1075-1078
Author(s):  
Steven P. Serlin ◽  
Mary Ellen Rimsza ◽  
John H. Gay
Keyword(s):  
Abdominal Pain ◽  
Case Report ◽  
Acute Appendicitis ◽  
Mexican American ◽  
Community Hospital ◽  
Good Health ◽  
Low Grade ◽  
New Approach ◽  
Rare Manifestation ◽  
Comprehensive Discussion

Rheumatic pneumonia is a well-described, poorly understood, rare manifestation of rheumatic fever that is generally fatal. Until 1958, when Brown and his colleagues presented their comprehensive discussion, pediatric journals provided only five references. Since then, only one article has appeared in the pediatric literature. As illustrated by the following case report, pediatricians need to be aware of rheumatic pnuemonia in order to determine optimal therapy and management. CASE REPORT A.M., a 13-year-old Mexican-American boy, was in apparent good health until he developed fleeting arthralgia, abdominal pain, and low-grade fever. The day following the onset of symptoms acute appendicitis was suspected, and a laparotomy was performed at a community hospital.

Sign in / Sign up

Export Citation Format

Share Document