Difference between revisions of "Interval appendectomy"
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==General== | ==General== | ||
*Done to exclude neoplasm and recurrent appendicitis.<ref name=pmid31175422>{{cite journal |authors=de Jonge J, Bolmers MDM, Musters GD, van Rossem CC, Bemelman WA, van Geloven AAW |title=Predictors for interval appendectomy in non-operatively treated complicated appendicitis |journal=Int J Colorectal Dis |volume=34 |issue=7 |pages=1325–1332 |date=July 2019 |pmid=31175422 |doi=10.1007/s00384-019-03303-4 |url=}}</ref> | *Done to exclude neoplasm and prevent recurrent appendicitis.<ref name=pmid31175422>{{cite journal |authors=de Jonge J, Bolmers MDM, Musters GD, van Rossem CC, Bemelman WA, van Geloven AAW |title=Predictors for interval appendectomy in non-operatively treated complicated appendicitis |journal=Int J Colorectal Dis |volume=34 |issue=7 |pages=1325–1332 |date=July 2019 |pmid=31175422 |doi=10.1007/s00384-019-03303-4 |url=}}</ref> | ||
*Histologically may mimic Crohn's disease.<ref name=pmid12883248>{{cite journal |authors=Guo G, Greenson JK |title=Histopathology of interval (delayed) appendectomy specimens: strong association with granulomatous and xanthogranulomatous appendicitis |journal=Am J Surg Pathol |volume=27 |issue=8 |pages=1147–51 |date=August 2003 |pmid=12883248 |doi=10.1097/00000478-200308000-00013 |url=}}</ref><ref name=pmid35076982>{{cite journal |authors=Malvar G, Peric M, Gonzalez RS |title=Interval appendicitis shows histological differences from acute appendicitis and may mimic Crohn disease and other forms of granulomatous appendicitis |journal=Histopathology |volume=80 |issue=6 |pages=965–973 |date=May 2022 |pmid=35076982 |doi=10.1111/his.14621 |url=}}</ref> | |||
==Microscopic== | ==Microscopic== | ||
Features: | Features:<ref name=pmid35076982/> | ||
*Muscularis propria eosinophils and/or plasma | *Muscularis propria eosinophils and/or [[plasma cell]]s. | ||
*+/-Muscularis propria | *+/-Fibrosis. | ||
*+/-Neutrophils in muscularis propria. | |||
*+/-Muscularis propria [[neutrophil]]s. | |||
*+/-Granulatous or xanthogranulomatous inflammation. | |||
DDx: | DDx: | ||
*[[Negative appendectomy]] - specimen should be [[submitted in toto]], no lymphoid hyperplasia, history is essential. | *[[Acute appendicitis]] - history is essential to differentiate. | ||
**An interval appendectomy may have active inflammation.<ref name=pmid35076982/> | |||
*[[Negative appendectomy]] - specimen should be [[submitted in toto]], no lymphoid hyperplasia, no chronic inflammation, history is essential. | |||
*[[Adenovirus appendicitis]] - lymphoid hyperplasia. | *[[Adenovirus appendicitis]] - lymphoid hyperplasia. | ||
*[[Mucinous_tumours_of_the_appendix|Mucinous tumour]] - | *[[Mucinous_tumours_of_the_appendix|Mucinous tumour]] - usually apparent on gross. | ||
*[[Appendiceal neuroendocrine tumour]]. | *[[Appendiceal neuroendocrine tumour]]. | ||
*[[Granulomatous appendicitis]]. | *[[Granulomatous appendicitis]]. | ||
*[[Crohn's disease]] of the appendix. | *[[Crohn's disease]] of the appendix - history is essential.<ref name=pmid12883248>{{cite journal |authors=Guo G, Greenson JK |title=Histopathology of interval (delayed) appendectomy specimens: strong association with granulomatous and xanthogranulomatous appendicitis |journal=Am J Surg Pathol |volume=27 |issue=8 |pages=1147–51 |date=August 2003 |pmid=12883248 |doi=10.1097/00000478-200308000-00013 |url=}}</ref> | ||
==Sign out== | ==Sign out== | ||
<pre> | <pre> | ||
Vermiform Appendix, Appendectomy: | Vermiform Appendix, Appendectomy: | ||
- Benign appendix with | - Benign appendix with mixed muscularis inflammation (plasma cells, eosinophils) and fibrosis, see comment. | ||
- NEGATIVE for acute appendicitis. | |||
Comment: | Comment: | ||
The operative report describes an interval appendectomy; the | The operative report describes an interval appendectomy; the findings would be compatible with that. | ||
</pre> | </pre> | ||
| Line 31: | Line 38: | ||
==References== | ==References== | ||
{{Reflist| | {{Reflist|2}} | ||
[[Category:Gastrointestinal pathology]] | [[Category:Gastrointestinal pathology]] | ||
Latest revision as of 17:45, 20 December 2023
Interval appendectomy is an appendectomy following the presentation of acute appendicitis.[1]
General
- Done to exclude neoplasm and prevent recurrent appendicitis.[2]
- Histologically may mimic Crohn's disease.[3][4]
Microscopic
Features:[4]
- Muscularis propria eosinophils and/or plasma cells.
- +/-Fibrosis.
- +/-Neutrophils in muscularis propria.
- +/-Muscularis propria neutrophils.
- +/-Granulatous or xanthogranulomatous inflammation.
DDx:
- Acute appendicitis - history is essential to differentiate.
- An interval appendectomy may have active inflammation.[4]
- Negative appendectomy - specimen should be submitted in toto, no lymphoid hyperplasia, no chronic inflammation, history is essential.
- Adenovirus appendicitis - lymphoid hyperplasia.
- Mucinous tumour - usually apparent on gross.
- Appendiceal neuroendocrine tumour.
- Granulomatous appendicitis.
- Crohn's disease of the appendix - history is essential.[3]
Sign out
Vermiform Appendix, Appendectomy: - Benign appendix with mixed muscularis inflammation (plasma cells, eosinophils) and fibrosis, see comment. - NEGATIVE for acute appendicitis. Comment: The operative report describes an interval appendectomy; the findings would be compatible with that.
See also
References
- ↑ Quartey B (July 2012). "Interval appendectomy in adults: A necessary evil?". J Emerg Trauma Shock 5 (3): 213–6. doi:10.4103/0974-2700.99683. PMC 3440885. PMID 22988397. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3440885/.
- ↑ de Jonge J, Bolmers MDM, Musters GD, van Rossem CC, Bemelman WA, van Geloven AAW (July 2019). "Predictors for interval appendectomy in non-operatively treated complicated appendicitis". Int J Colorectal Dis 34 (7): 1325–1332. doi:10.1007/s00384-019-03303-4. PMID 31175422.
- ↑ 3.0 3.1 Guo G, Greenson JK (August 2003). "Histopathology of interval (delayed) appendectomy specimens: strong association with granulomatous and xanthogranulomatous appendicitis". Am J Surg Pathol 27 (8): 1147–51. doi:10.1097/00000478-200308000-00013. PMID 12883248.
- ↑ 4.0 4.1 4.2 Malvar G, Peric M, Gonzalez RS (May 2022). "Interval appendicitis shows histological differences from acute appendicitis and may mimic Crohn disease and other forms of granulomatous appendicitis". Histopathology 80 (6): 965–973. doi:10.1111/his.14621. PMID 35076982.