Talk:Vermiform appendix

Acute appendicitis with periappendicits - children

Microscopic description

The sections show appendiceal mucosa with focal ulceration and reactive mucosal lymphoid hyperplasia. The muscularis propria is infiltrated by inflammatory cells (including, lymphocytes, neutrophils and eosinophils), which are also found at the serosal surface. The proximal resection margin is intact. Ganglion cells are present.

Final diagnosis

Vermiform appendix, appendectomy - acute appendicits with periappendicitis.

Checklist approach - to the routine appendix

Microscopic description

Neutrophils in muscularis propria - present.
Inflammation at the serosal surface - present.
Site of perforation identified - no.

Granulomatous inflammation - not identified.
Crypt architectural changes - not present.

Lymphoid hyperplasia - present.
Submucosal fibrosis - absent.

Fecalith - not identified.
Infectious organisms - not identified on routine stains.

Resection margin viable - yes.
Ganglion cells - present.

Final diagnosis

Vermiform appendix, appendectomy:
- Acute appendicits.
- Acute periappendicitis.

Sort of negative appy - GS

Microscopic description

The sections show appendiceal mucosa with focal ulceration, as demonstrated by intraluminal debris and neutrophils, and marked reactive mucosal/submucosal lymphoid hyperplasia. There are no granulomas and no crypt architectural changes of chronic inflammation. The muscularis propria is not infiltrated by inflammatory cells, nor is the serosal surface. The proximal resection margin is intact. Ganglion cells are present.

Final diagnosis

Vermiform appendix, appendectomy - acute inflammation, see microscopic description.

Negative appy

Microscopic description

The sections show normal large bowel wall with abundant mucosal and submucosal lymphoid tissue. The muscularis propria is not infiltrated by inflammatory cells, nor is the serosal surface. The proximal resection margin is intact. Ganglion cells are present.

Final diagnosis

Vermiform appendix, appendectomy - no pathology.

Interval appy - GS

Microscopic description

The sections show reactive mucosal/submucosal lymphoid hyperplasia and submucosal fibromuscular hyperplasia. There is focal granulation tissue formation and intestinal crypt changes, including branching, as seen in repair. Scattered hemosiderin-laden macrophages are present. The muscularis propria is not infiltrated by inflammatory cells, nor is the serosal surface. The proximal resection margin is intact. Ganglion cells are present.

Final diagnosis

Vermiform appendix, (interval) appendectomy - lymphoid hyperplasia with fibromuscular hyperplasia, consistent with recent appendicitis.

More than acute appy?

Vermiform Appendix, Appendectomy:
- Acute appendicitis with acute periappendicitis, reactive epithelial changes, focally prominent benign neural tissue 
  and marked active mucosal inflammation, see comment. 

Comment:
The sections show marked active mucosal inflammation (microabscesses). This may be acute appendicitis only; however, the possibility of a secondary inflammatory process (infection, ischemia, inflammatory bowel disease, iatrogenic causes) should be considered. The specimen is NEGATIVE for granulomatous inflammation. Clinical correlation is recommended.