Unusual Histopathological Findings in Appendectomy Specimens Obtained from 1683 Pediatric Patients with Suspected Acute Appendicitis
The aim of this study is to emphasize the importance of rare histopathological findings in appendix specimens of pediatric patients who underwent surgery for the preliminary (underwent appendectomy to treat an initial diagnosis) diagnosis of acute appendicitis. In this study, the demographic and histopathologic data of 1683 patients who underwent surgery for (presumed acute appendicitis) acute appendicitis between 2011 and 2017 were retrospectively evaluated. Appendectomy specimens were classified microscopically as appendix vermiformis, lymphoid hyperplasia, acute appendicitis, phlegmonous appendicitis, gangrenous appendicitis, perforated appendicitis, and unusual histopathological findings. Age, sex, clinical features, surgical reports, and macroscopic and microscopic features of appendix vermiformis were evaluated in patients with unusual histopathological findings. Ages of these 1683 patients ranged between 6 months and 17 years; among them, 1091 were men and 592 were women. Pathology reports included acute appendicitis (n = 827), phlegmonous appendicitis (n = 300), lymphoid hyperplasia (n = 274), perforated appendicitis (n = 181), appendix vermiformis (n = 50), gangrenous appendicitis (n = 3), and abnormal findings (n = 48). Of the 48 patients who were detected to have unusual findings, 32 were women and 16 were men and their ages ranged from 6 to 17 years. The frequency of unusual histopathological findings were as follows: Enterobius vermicularis (n = 37), fibrous obliteration (n = 6), neuroendocrine tumor (n = 2), mucinous neoplasm (n = 1), pseudodivericulitis (n = 1), and foreign body in the lumen (n = 1). No tumor recurrence or distant metastasis developed during the 2-year follow-up in any of the three patients detected to have a tumor. Even if the appendectomy specimen is normal during the surgery, histopathologic evaluation is necessary for the diagnosis of diseases that require treatment and follow-up after surgery.
KeywordsAppendicitis Carcinoid Enterobius vermicularis Unusual findings Pseudodiverticulitis
All of the authors declare that they have all participated in the design, execution, and analysis of the paper, and that they have approved the final version.
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no conflict of interest.
- 6.Yilmaz M, Akbulut S, Kutluturk K, Sahin N, Arabaci E, Ara C, Yilmaz S (2013) Unusual histopathological findings in appendectomy specimens from patients with suspected acute appendicitis. World J Gastroenterol 19(25):4015–4022. https://doi.org/10.3748/wjg.v19.i25.4015 CrossRefPubMedPubMedCentralGoogle Scholar
- 8.Akbulut S, Tas M, Sogutcu N, Arikanoglu Z, Basbug M, Ulku A, Semur H, Yagmur Y (2011) Unusual histopathological findings in appendectomy specimens: a retrospective analysis and literature review. World J Gastroenterol 17(15):1961–1970. https://doi.org/10.3748/wjg.v17.i15.1961 CrossRefPubMedPubMedCentralGoogle Scholar
- 9.Yabanoglu H, Caliskan K, Ozgur Aytac H, Turk E, Karagulle E, Kayaselcuk F, Akin TM (2014) Unusual findings in appendectomy specimens of adults: retrospective analyses of 1466 patients and a review of literature. Iran Red Crescent Med J 16(2):e12931. https://doi.org/10.5812/ircmj.12931 CrossRefPubMedPubMedCentralGoogle Scholar
- 17.Hatzipantelis E, Panagopoulou P, Sidi-Fragandrea V, Fragandrea I, Koliouskas DE (2010) Carcinoid tumors of the appendix in children: experience from a tertiary center in northern Greece. J Pediatr Gastroenterol Nutr 51(5):622–625. https://doi.org/10.1097/MPG.0b013e3181e05358 CrossRefPubMedGoogle Scholar
- 21.Rich BS, Roychoudhury S, Williamson AK, Glick RD (2017) Pediatric mucinous neoplasm of the appendix presenting as a mucocele: a case report and review of the literature. J Pediatr Surg Case Rep 17:11e14Google Scholar
- 22.Altieri ML, Piozzi GN, Salvatori P, Mirra M, Piccolo G, Olivari N (2017) Appendiceal diverticulitis, a rare relevant pathology: presentation of a case report and review of the literature. International Journal of Surgery Case Reports 33:31–34. https://doi.org/10.1016/j.ijscr.2017.02.027 CrossRefPubMedPubMedCentralGoogle Scholar
- 23.Yardimci AH, Bektas CT, Pasaoglu E, Kinaci E, Ozer C, Sevinc MM, Mahmutoglu AS, Kilickesmez O (2017) Retrospective study of 24 cases of acute appendiceal diverticulitis: CT findings and pathological correlations. Jpn J Radiol 35(5):225–232. https://doi.org/10.1007/s11604-017-0625-z CrossRefPubMedGoogle Scholar
- 26.Klingler PJ, Seelig MH, DeVault KR, Wetscher GJ, Floch NR, Branton SA, Hinder RA (1998) Ingested foreign bodies within the appendix: a 100-year review of the literature. Dıgest Dıs 16(5):308–314Google Scholar