Retrospective analysis of the appendiceal neoplasms: sampling technique may influence neoplasm detection

Abstract

Background and aimsAppendiceal neoplasms are uncommon entities that are usually determined incidentally during the histopathological examination. Different techniques used for the macroscopic sampling of appendectomy material may affect the determinating neoplasms.Materials and methodsH&E-stained slides of 1280 cases who underwent appendectomy between 2013 and 2018 were reviewed retrospectively for histopathological features.ResultsNeoplasms were determined in 28 cases (3.09%); 1 lesion was observed in the proximal part of the appendix, 1 covering the entire length from proximal to distal and 26 in the distal part. In the 26 cases that observed in the distal part, the lesion was seen on both sides of the longitudinal section of the distal appendix in 20 cases, while it was seen on only one distal longitudinal section in the remaining 6 cases.ConclusionThe vast majority of appendiceal neoplasms are seen in the distal part of the appendix, and, in some cases, neoplasms might be seen on only one side of the distal section. Sampling only one-half of the distal part of the appendix, where tumours are most often observed, could result in some neoplasms being missed. Therefore, sampling the whole distal part would be more beneficial to determine small diameter tumours that do not create macroscopic findings.

High Incidence of Appendiceal Neoplasms in the Elderly: A Critical Concern for Non-Surgical Treatment

“…Another potential explanation for the increasing incidence of ANs may be related to changes in techniques for pathological assessment. Studies suggest that a more extensive examination of specimens, with a greater representation of sections submitted for each case, may be influential in the detection of tumors [ 4 , 16 ]. In our daily practice, we often submit the entire appendix for pathological examination.…”

“…In our cohort, the presenting symptom of most cases of ANs was right lower abdominal pain, accompanied by defense and/or rebound tenderness. Numerous studies have shown that ANs rarely have distinct clinical features and often present appendicitis-like symptoms [ 4 , 5 ]. We observed that the mean preoperative WBC count in AN cases was 11.5 × 10 3 /μL, whereas the accepted standard WBC count in our laboratory ranges from 4,500 to 11,000 × 10 3 /μL.…”

“…Despite the diverse spectrum of ANs, they often present with appendicitis-like symptoms and are often discovered incidentally during histopathological examination [ 4 , 5 ]. Imaging modalities such as ultrasonography and computed tomography (CT) are helpful in identifying features of ANs, such as an enlarged or thickened appendix, calcifications, or nodules [ 5 , 6 ].…”

Seeds or parasites? clinical and histopathological features of seeds and parasites in the appendix

“…In the reproductive organs of females, 50-60 µm by 20-30 µm "D-shaped" eggs can be observed (71). Taenia spp., generally 2-12 mm in length, are rarely observed in appendectomy specimens (2,3). In most cases, the egg form is seen in the lumen.…”

“…Other parasites, such as Taenia subspecies (Taenia spp. ), Balantidium coli, Entamoeba histolytica, Schistosoma , and Ascaris lumbricoides , are less common ( 2 , 3 ). If parasites are detected in appendectomy materials, stand-alone application of appendectomy is not sufficient for treatment.…”