Appendix findings in pseudomyxoma peritonei were also excluded since appendix involvement is inevitable either clinically and/or microscopically in such cases. Cases of Perforation / Acute / Chronic appendicitis were excluded from further evaluation. Old registers were searched for the keyword “Appendix” in the organ column and the corresponding entry in the diagnosis column was looked at. For such studies, institutional review board permission is waived off in our institute. No new test was performed and patient anonymity was ensured. Only microscopic re-evaluation of archival glass slides with tissue from vermiform appendix was performed. Our retrospective cross-sectional study encompasses cases that have been diagnosed in our institute over a period of about ten years (January 2007 - April 2017). Hopefully, our cases also reinforce that dismissing the organ at the operating/grossing table may sometimes at least, be at the patients’ peril. This bouquet of select cases we hope, serves as a reminder for the surgeons and pathologists to the multitude of lesions possible in the appendix. While the lesions we will discuss are not very uncommon, the situations surrounding the diagnosis, for the most part, are. Our article pertains to a series of some incidentally detected or unsuspected appendiceal lesions diagnosed over the past decade at our institute. However, once in a while, for those that care to dig, its little chamber of secrets does provide the odd surprise reminiscent of a jack-in-the-box toy. Often condemned to the last pages of chapters, for surgeons and pathologists alike appendix embodies a troublesome organ notoriously prone to inflammation and perforation. The appendix is considered an appendage of little value, its name probably derived from the synonym implying a postscript or supplement. 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. Sampling and histopathologic assessment of the appendix should be compulsory, careful and representative. 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. Among these, 25 had a normal-appearing appendix and 27 were not suspected on radiology or on clinical/surgical assessment. Among the recorded rare diagnoses, one representative case each, based on interesting history or pathology, was selected for discussion.įorty-three lesions were found to meet inclusion criteria comprising 12 varied etiologies. 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.Īll appendectomy specimens over ten years were screened for diagnosis other than acute/chronic/resolving appendicitis and pseudomyxoma peritonei. 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. 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.
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