![]() ![]() Submucosal granuloma with central necrosis (HE × 40) F: Moderately differentiated adenocarcinoma showing infiltration of the mucosa and submucosa of the appendiceal wall (HE × 100) G: Adenocarcinoma of the appendix showing associated mucocele on the top right side (HE × 100) H: Mucocele showing a unilocular dilated appendiceal wall lined with flattened epithelial cells (HE × 100) I: Eggs of Taenia sup are present in the lumen of appendix vermiformis (HE × 100) J: Serosa of the appendiceal wall showing diffuse large B cell lymphoma infiltration (HE × 40). We conclude that appendiceal neuroma is a rather common entity, and that most cases of so-called fibrous obliteration actually represent appendiceal neuroma.Figure 1 Unusual histopathologic findings.Ī: Appendix vermiformis showing fibrous obliteration B: View of the enterobius vermiformis in the lumen of appendix vermiformis (HE × 100) C: Mucinous cystadenoma showing proliferation of neoplastic adenomatous epithelium, which exhibits low-grade dysplasia (HE × 100) D: Carcinoid tumor of the appendix showing rounded nests and tubules of tumor cells with uniform nuclei (HE × 200) E: Granulomatous inflammation. result normal appendix, serositis, fibrous obliteration, inflammation outside the appendix/periappendicitis such as diverticular disease/endometriosis. Ultrastructural examination of one case confirmed the presence of a mixture of Schwann cells and cells containing neurosecretory granules. In patients with active UC treated with appendectomy, clinical characteristics and RHI scores were compared between endoscopic and non-endoscopic response. All were diag- nosed incidentally by the pathologist in appendices removed en passant. In all patients with UC, clinical characteristics were compared between no appendiceal inflammation, active appendiceal inflammation, and total fibrous obliteration of the appendix. Stains for vasoactive intestinal polypeptide, substance P, neurotensin, bombesin and gastrin were negative. associated with fibrous obliteration of the appendiceal lumen. Two appendiceal neuromas contained somatostatin positive cells. With regard to histopathological type, submucosal neurogenic hyperplasia was present in five patients and fibrous obliteration in three patients. In four cases, another associated disease accounted for the pain in the RIF. In 5 of 11 cases with apparent uninvolved appendix present in the specimen, the number of serotonin cells in the crypts was greater than in normal appendix controls. and were operated on due to a diagnosis of acute appendix, with a simple appendectomy being performed. In 12, serotonin positive cells entrapped in the proliferation were present. The spindle cells were positive for S-100 protein and neuron-specific enolase in all cases. One was central with nodularity and two were confined to the mucosa. Conclusion: All appendectomy specimens must be submitted to the pathologist for histological diagnosis. Seventeen were located centrally in the appendix without nodule formation. The most common unusual causes were parasites (37), mainly schistosomiasis (24.3), followed by neoplasm (20) and fibrous obliteration (14.2). We have studied 20 examples, 7 discovered during a prospective examination of 26 consecutive routine appendectomy specimens (for an incidence of 27%), 2 selected from random cases, and 11 discovered in a retrospective review of 11 randomly selected cases of appendices diagnosed as "fibrous obliteration." By light-microscopy, appendiceal neuromas appear as a loose proliferation of spindle cells usually in a myxoid background, frequently with entrapped fat and connective tissue and infiltrated by eosinophils. The neural origin and even the existence of appendiceal neuromas have been questioned. ![]()
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