Acta Biomedica Scientifica (Sep 2017)
Pathomorphological diagnostics of chronic appendicitis (literature review)
Abstract
The review is devoted to the problem of diagnostics and differential diagnostics of chronic appendicitis. As it is commonly known, the very existence of chronic appendicitis is still considered controversial. The article describes the current ideas on chronic appendicitis (primary, secondary, residual and recurrent), presents the list of morphological manifestations in the vermiform appendix at chronic inflammation, discovered at routine histological examination: dystrophic changes in the form of atrophy of all layers of appendix with sclerosis or hypotrophy of various degree, up to appendiclausis and disappearance of mucous membrane, and lipomatosis of submucosa. The authors discuss the complexity of diagnostics predetermined by lack of precise criteria of the disease; show the possibility of evaluation of the expression of cytoadherence molecules for diagnostics of the disease, in particular of VCAM-1 and ICAM-1 for differential diagnostics of chronic appendicitis. The role of suppressor of signal cytokine proteins SOCS3 in chronic inflammation is discussed. The data demonstrate the increase of T-lymphocytes and neurons in chronic appendicitis as an increase of PGP 9.5 (panneuronal marker protein gene product 9.5) level. It has been shown, that immunohistochemical staining on p44 MAPK has an advantage in differential diagnostics of chronic appendicitis - specific staining of subserous and muscle layer of the wall is observed only at the discussed pathology of the appendix. In spite of multiple studies and acknowledgment of the fact that chronic form of appendicitis is a separate disease, the diagnostics of this pathology still presents quite a problem especially when only routine methods of examination are used. Thus, we found it necessary to introduce additional immunomorphologic methods into the clinical practice.
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