HISTOLOGICAL SPECTRUM OF APPENDICULAR LESIONS, TEN YEARS’ EXPERIENCE AT A TERTIARY CARE HOSPITAL

Abstract

Objective: To determine the frequency of histopathological entities in appendectomy specimens.

Material and Methods: This descriptive retrospective study was done for ten years from Jan 2011 to Dec 2020 at the department of pathology, Combined Military Hospital, Kharian. All surgically removed appendectomy specimens received for histopathology were included in the study. The appendix, resected along with other organs like with uterus or intestine, was excluded from the study. The clinical and demographic details of the patient were retrieved from request forms. All cases were reviewed. Only those cases were excluded from the study for which blocks were not available (taken for review). Descriptive statistics were calculated.

Results: A total of 883 specimens, which were fulfilling inclusion and exclusion criteria were analyzed. Out of these, 597(67.6%) were males and 286(32.4%) were females. Among non-neoplastic entities (99.44%) acute suppurative appendicitis with periappendicitis  (31.9%), appendix showing reactive lymphoid hyperplasia (26.2%) were the common diagnosis, while parasitic infestation of Entrobious Vermicularis (4.8%), chronic appendicitis with fibrosis (3.2%), appendix showing congestion and fecolith (2.0%) and granulomatous appendicitis 2 (0.2%) were seen less frequently. Only five were neoplastic, including mucinous cystadenoma (0.3%), carcinoid tumor (0.1%), and mucinous adenocarcinoma (0.1%).

Conclusion: The routine histopathology examination of all appendectomy specimens should be considered mandatory as it not only confirms the clinical diagnosis of acute appendicitis but also explores the incidental unusual pathologies, which are to be missed on gross examination, including parasitic infestation, granulomatous appendicitis and mucinous neoplasms.

Key Words: Appendix, Appendicitis, Parasite, Mucinous, Periappendiitis.