Incidental Findings in Routine Histopathological Examination of Appendectomy Specimens; Retrospective Analysis of 1970 Patients

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 , 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.

Impact of routine histopathological examination of appendectomy specimens on patient management: a study of 4012 appendectomy specimens

“…Appendectomy only treats the consequences but not the cause of the disease. For this reason, these patients should also receive anthelmintic treatment (oral mebendazole) (14). In the present study, fourteen patients (0.3 %) had E. ver- micularis in their specimens, with the incidence being slightly lower than that of other published studies.…”

“…Carcinoid tumour of the appendix is the most common type of primary malignant tumour of the appendix. It represents 60% of all appendiceal tumours and is discovered in 0.3% to 2.3% of the appendectomy specimens (1,14). In the current study, we had slightly lower incidence of appendiceal carcinoids (0.1%) compared to other studies.…”

“…Although acute appendicitis is the most common histopathological finding affecting the appendix, chronic appendicitis was the most common unusual finding on HPE of the appendectomy specimens in the current study. Chronic appendicitis does not present with typical symptoms of acute appendicitis and diagnosis is frequently made following an appendectomy and based on HPE (14). In our study, the rate of chronic appendicitis was 5.2%.…”

“…In our study, the rate of chronic appendicitis was 5.2%. Shreshtha et al and Dincel et a. havel reported lower rates of 2.6% and 0.2%, respectively (9,14). In a study conducted by Rehman et al, 7.9% of a total of 316 patients has been found to have chronic appendicitis (15).…”

“…Patients with Schistosomal appendicitis should be treated with praziquantel after surgery (14). The incidence of Schistosomal appendicitis was reported to be 0.1% by Dincel et al (14) and 2.3% by Gali et al (17). In the current study, 8 (0.2%) cases had Schistosomiasis.…”