Unusual Histopathological Findings of Appendectomy Specimens

Abstract

Background: Appendicitis is a very common surgical clinical condition and appendectomy is a frequently performed procedure worldwide. Although obstruction caused by fecoliths or lymphoid aggregation is a common reason for appendicitis, unusual histopathological findings can be a cause too. Unusual findings can range from benign conditions like worm infestation and cysts to malignant conditions like carcinoid tumors and adenocarcinomas. Enterobius vermicularis infection, tuberculosis, ascaris lumbricoides infestation, carcinoid tumors and cystadenomas are some of the commonly appearing unusual findings. Objective: To document the number of rare histopathological findings of appendectomy specimens. Methods: A 7 year retrospective study was conducted at Ziauddin University Hospital from March 2005 to December 2012. From accumulated information for 2157 appendectomies, 138 appendectomy specimens had rare histopathological findings. Incidental and negative appendectomies were excluded from this study. Results: 58% of the patients with unusual histopathological findings were males (n=80) and 42% were females (n=58). Most common findings included: Enterobius vermicularis48.5%(n=67), Tuberculosis13% (n=18), Carcinoid tumors 9% (n=13) and cystadenomas 8% (n=11). Other findings include: peri appendicular abscess, adenocarcinoma of colonic origin, necrotizing lymphadenitis, ascaris lumbroides, Meckel’s diverticulum, taenia saginata, pheochromocytoma and mucocele. Conclusion: Appendectomy specimens should be routinely sent for histopathological examinations as this practice can help in diagnosing rare tumors and conditions. Key Words: Appendicitis, Histopathological Findings, Appendectomies, Enterobius Vermicularis, Tuberculosis infestation, Carcinoid tumors, Cystadenomas.