Histopathological Evaluation of Lesions of Appendix - A Cross Sectional Study

Author(s): Asha Peedikayil Punnoose1, Elizabeth Joseph2, Dahlia Joseph3, Blessy Mary Thomas4, Sunit Varghese Thomas5, Reily Ann Ivan6

Appendix is considered as a vestigial organ in medical history. But recent studies
reveal its importance in immunological function. Appendicectomy is one of the
most common surgeries performed and acute appendicitis being the most frequent
pathology noted. Various less common pathologies like parasitic infestation,
granuloma, diverticulum, neoplasms are also described. In our institute, we have
seen an increased rate of acute appendicitis and a relative increase in neoplastic
conditions. The purpose of this study was histopathological evaluation of lesions
of appendix over a period of five years and its association with demographic data.
This cross-sectional study included all specimens received in the department of
pathology with primary pathology in appendix. Appendix removed as a part of
other surgical procedures were excluded. Relevant clinical data, gross findings and
histopathological diagnoses were retrieved from pathology records and computer
databases and statistical analysis was done using Statistical Package for Social
Sciences (SPSS 16.0).
Out of the 576 cases, 485 (84 %) patients showed findings consistent with acute
appendicitis on histopathological examination. Perforation rate was 4.86 % and
was higher in male patients. Other pathologies include chronic appendicitis in 58
cases (10.06 %), eosinophilic appendicitis in one case (0.17 %), appendix with
lymphoid hyperplasia in 14 cases (2.43 %), periappendicitis in 4 cases (0.69 %),
fibrous obliteration of appendix in 2 cases (0.34 %), granulomatous appendicitis
in 4 cases (0.69 %), appendix with lymphoid hyperplasia in 14 cases (2.43 %),
diverticulitis in one case (0.17 %), tubular adenoma with low grade dysplasia in
one case (0.17 %), neuroendocrine tumour in one case (0.17 %) and mucinous
neoplasms in 5 cases (0.86 %).
The study supports routine histological examination of all the appendicectomy
specimens to avoid missing of any clinically important condition which has
significant impact on treatment and prognosis. Also noted an increased number of
mucinous neoplasms suggesting the importance of future studies in this field.