Lipomatosis of appendix in a teenager

Shanmugarajah, Inthujan; Sundrehagen, Bendik H; Warberg, Eivind; Kazaryan, Airazat M.

doi:10.1002/ccr3.4595

Cited by 3 publications

(3 citation statements)

References 13 publications

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“…Prevalence of the colonic submucosal lipomatosis has been reported as 0.2%. (9,11). In the ileocecal valve, moderate lipomatosis has been observed in 40% of the cases, and severe lipomatosis in 14% of the cases (12).…”

Section: Discussionmentioning

confidence: 99%

“…In 36% of the patients operated with a prediagnosis of AA, lymphoid hyperplasia, fecalitis, enterobius vermicularis, carcinoid tumor, or adenoma were determined without transmural inflammation in microscopic examination of the appendix (4). 'Submucosal lipomatosis' is another entity that has been rarely reported in patients who were followed up or operated with prediagnosis of AA (6)(7)(8)(9). The histological layers of the gastrointestinal segments are mucosa, submucosa, muscularis propria, and serosa from inside to outside.…”

Section: Introductionmentioning

confidence: 99%

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Is Submucosal Lipomatosis of the Appendix Vermiformis Really a Rare Entity?

Ay Haldız

2024

Harran Üniversitesi Tıp Fakültesi Dergisi

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Background: Acute appendicitis (AA) is the most common surgical emergency in patients who visit the emergency department with abdominal pain. In some of the patients who were operated with a prediagnosis of AA, lymphoid hyperplasia, fecalitis, enterobius vermicularis, carcinoid tumor, or adenoma are determined without transmural inflammation in microscopic examination of the appendix. 'Submucosal lipomatosis' is also another entity that has been rarely reported in appendix localization. In this study, we aimed to determine the frequency and severity of submucosal fatty tissue (SFT) in appendectomy specimens and identify risk factors. Materials and Methods: 293 appendectomy specimens were evaluated retrospectively. The amounts of SFT (A0: None, A1: Isolated adipocytes (Mild), A2: Small adipocyte groups (Moderate), A3: Prominent adipocyte groups (Marked), A4: Severe adipocyte groups that narrow the lumen (Severe)) and the groups that were created according to the amounts of SFT (Group 1: Cases with A1,2,3,4, group 2: Cases with A2,3,4, group 3: Cases with A3,4) were determined in hematoxylin-eosin sections. Results: 91.47% of the cases had any amount of SFT. Amounts of SFT were mild in 23.89%, moderate in 46.76%, marked in 18.09%, and severe in 2.73%. All of the cases without SFT were in pediatric age. When the amount of SFT increased, the mean age and adult rate increased regularly (p<0.05). As 68% of the cases without SFT were female, male predominance was observed in cases with SFT. When the amount of SFT increased, male rate increased regularly (p<0.05). AA wasn’t determined in 26,28% of the cases. The AA rate in the group without SFT (20%) was marked lower than group 1 (78,73%), group 2 (82,32%), and group 3 (83,87%) (p<0.05). The most prominent increase in AA rate was between the group without SFT and group 1 which was the most sensitive group to the amount of SFT. When group 1,2,3 were compared, no significant increase in the AA ratio was found. Conclusions: The presence of SFT in the appendix is a common condition. Age increase and male gender are risk factors for the accumulation of SFT. Due to SFT accumulation increases the risk of AA, it would be logical to classify it as mild/moderate/marked/severe, and accept it as 'Submucosal lipomatosis'.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Is Submucosal Lipomatosis of the Appendix Vermiformis Really a Rare Entity?

Ay Haldız

2024

Harran Üniversitesi Tıp Fakültesi Dergisi

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“…No surprise then, that it may affect the appendix or the periappendiceal tissue. Strangely though, case reports of “appendiceal” lipoma are few and far between and frequently in the context of complications such as torsion [ 19 - 21 ]. One may thereby infer that it may be perceived to be so common that is underreported or that it may genuinely be a rare entity, especially the subserosal type as was seen in our case.…”

Section: Discussionmentioning

confidence: 99%

Vermiform Appendix and the Potential for Missed Pathologies

Patel¹,

Singh²,

Umamahesweran³

et al. 2022

Cureus

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Introduction The appendix is considered an appendage of little value and is often treated disdainfully, be it as part of evolutionary process, on a grossing table, under a microscope or while archiving specimens and slides. It is only recently, with data indicating its importance in gut immunity and as the origin of pseudomyxoma, that its space in a human body appears vindicated. Aim Our aim was to screen the histopathologic spectrum of appendix lesions observed in our hospital for rare, incidental or clinico-radiologically uncertain lesions that would help emphasize a necessary seriousness in its sampling. Method All appendectomy specimens over ten years were screened for diagnosis other than acute/chronic/resolving appendicitis and pseudomyxoma peritonei. Among the recorded rare diagnoses, one representative case each, based on interesting history or pathology, was selected for discussion. Observation Forty-three lesions were found to meet inclusion criteria comprising 12 varied etiologies. Among these, 25 had a normal-appearing appendix and 27 were not suspected on radiology or on clinical/surgical assessment. Histopathology comprised, among others, neoplastic entities such as (Diffuse large B-cell) lymphoma, metastasis, carcinoid as well as interesting non-neoplastic diagnoses such as pinworm infestation (in the elderly) and (post-menopausal) endometriosis. Conclusion Sampling and histopathologic assessment of the appendix should be compulsory, careful and representative. Each specimen must be treated as harboring a potential pathology, until microscopically proven otherwise because missed “rare” diagnoses could delay therapy or alter key management decisions as cancer staging.

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A Focal Submucosal Lipomatosis

Chandanwale

Patel

Verma

et al. 2023

Indian Journal of Medical Specialities

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Gastrointestinal lipomatosis is less frequent condition and it differs from lipoma due to the lack of capsule. The most common location of gastrointestinal lipomatosis is colon, followed by the ileum and jejunum. Isolated lipomatosis of the appendix is rare. It can be diffuse, asymmetric, or focal. In the localized form, only few patients present with symptoms. Obstruction of the lumen of the appendix is thought to be the primary pathology of appendicitis. Various pathologies such as hard fecal mass, stones, lymphoid hyperplasia, and neoplasia have been implicated. Obstruction of the appendiceal lumen due to isolated submucosal lipomatosis of the appendix is extremely rare. It can be one of the causes of appendicitis. Although radiological modalities such as ultrasonography, computed tomography scan, and magnetic resonance imaging are used for diagnostic workups, definitive diagnosis requires histopathological examination.

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Lipomatosis of appendix in a teenager

Abstract: This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

Cited by 3 publications

References 13 publications

Is Submucosal Lipomatosis of the Appendix Vermiformis Really a Rare Entity?

Is Submucosal Lipomatosis of the Appendix Vermiformis Really a Rare Entity?

Vermiform Appendix and the Potential for Missed Pathologies

A Focal Submucosal Lipomatosis

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