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.

SNNL is not always benign. The possible causes of this lesion include parasites and metastatic tumors. It is important to identify the minute foci of metastatic carcinoma for the appropriate management of this lesion.

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IntroductionInflammatory myofibroblastic tumor as a rare neoplastic lesion is seen most commonly in the pulmonary system. Beside the presence of limited number of inflammatory myofibroblastic tumors of the gastrointestinal tract in the literature, co-existence with acute appendicitis has not been reported before.Presentation of caseA 27-year-old woman admitted to emergency department with acute abdominal pain at the right lower quadrant. The initial diagnosis was as acute appendicitis. Intraoperatively, a mass with a diameter of almost 5 cm originated from the distal ileal segments neighboring the appendix was seen. The patient was managed by segmental resection of the small intestine including the mass with appendectomy. Histologically, there were bundles of spindle cells accompanied by lymphoplasmocytic infiltration. The immunohistochemical studies showed that tumor cells were positive for smooth muscle actin, vimentin, perinuclear activity for anaplastic lymphoma kinase and CD 68. The final pathologic diagnosis was inflammatory myofibroblastic tumor.DiscussionConcomitant resection of tumoral lesions detected in the neighbor intestinal segments during appendectomy should be considered to diagnose and treat.For the diagnosis of inflammatory myofibroblastic tumor, immunohistochemistry pattern including positivity for actin, vimentin, CD 68 and anaplastic lymphoma kinase plays a crucial role. Therefore, detailed immunohistochemistry analysis should be performed in suspicious cases.ConclusionCoexistence of inflammatory myofibroblastic tumor located in the gastrointestinal system with acute appendicitis is a rare event. Complete surgical excision should be regarded as the mainstay of the treatment. Long-term follow up with serial imaging techniques is recommended.

Solid Pseudo-Papillary Neoplasia (SPN) is the rare tumors of the pancreas. The aim of the current study is documentation of the data of the patients. The data of patients with pancreatic neoplasm were presented to Gastroenterology Department between 2010 and 2014 were evaluated retrospectively. A database of the characteristics of these patients was developed, including demographic, laboratory, radiological, surgical and pathological features and the immuno-histochemical staining of tumor specimens. Analysis of 323 patients diagnosed with pancreas malignancies in our hospital between 2010 and 2014 demonstrated that 5 patients (1.5%) were diagnosed with SPN. Of these five patients, four were females and one was male. Their average age was 27 (range: 16-50). CA 19-9 levels were normal in four patients while slightly increase in one (60 U/mL (0-33)) and there were the other tumor markers under a normal range 5-10.3 cm diameter in size, mean: 7.6 cm. Immunohistochemical analysis demonstrated that CD10, CD56, Ki-67 and β-catenine was positive for all patients while other markers were variable. Progesteron and estrogen receptors were positive in histo-pathologic specimens of four patients. SPN is a rare tumor that develops principally in young women and has a good prognosis. Immunohistochemical staining is important in the differential diagnosis of SPN and estrogen positivity may have a role in pathogenesis of a limited patients.