Xanthogranulomatous Appendicitis

Abstract

A 78-years-old man presented with right lower quadrant pain for 2 months. Computed tomography revealed an irregular and multicystic mass near the cecum like as appedeceal mucocle. The lesion was diagnosed xanthogranulomatous appendicitis by histopathological findings of surgical specimen. Xanthogranuloma is uncommon disease, especially in the appendix. We report an interesting case of xanthogranulomatous appendicitis mimicking appendiceal mucocele in radiological images.Keywords Appendix . Xanthogranuloma A 78-year-old Japanese man was referred to our department by the general practitioner complaining of a 2-month history of right lower quadrant pain. He had no medical history. Blood examination showed no remarkable changes, and tumor markers were within the normal limits. An abdominal computed tomography (CT) revealed about 4 cm irregular and multicystic mass near the cecum (Fig. 1). On colonoscopy, a lesion protruding from the appendiceal orifice of the cecum was found and its top was covered with normal mucosa. Biopsy specimen revealed no malignancy. Based on CT and colonoscopy findings, the lesion was diagnosed as appendiceal mucocele. Subsequently the patient went for laparotomy, revealing 4×4 cm-sized irregular mass locating in the tip of the appendix. The patient underwent an ileocecal resection. Histopathological findings showed predominance

Xanthogranulomatous Appendicitis in a Child: Report of a Case and Review of the Literature

“…There appears to be a higher incidence of XA in interval appendectomies as noted by Guo and Greenson and seen in the cases by Singh et al, Chuang et al, and Mado et al [6, 7, 10, 12]. …”

“…The oldest patient diagnosed with XA was a 78-year-old Japanese man who presented with 2-month history of right lower quadrant abdominal pain [12]. …”

Cytological diagnosis of xanthogranulomatous appendicitis

“…[7] reported a case of a 78-year-old patient with abdominal pain, and the CT scan showed a 4-cm irregular mass near the caecum. The patient was operated with a clinical diagnosis of appendiceal mucocele, but the histopathological findings were consistent with XA.…”

Abdominal manifestations of histiocytic disorders in adults: imaging perspective

“…36 Xanthogranulomatous appendicitis is a very unusual type of appendicitis with around 10 cases reported in the literature 37 with a strong association with interval appendectomy. 38 On imaging, it may show features similar to an appendiceal mucocele or tumour-like thickening with or without involvement of the caecum 39 ( Figure 8a,b). Performing frozen section during surgery may suggest the diagnosis and radical surgery can be avoided.…”