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PubMed1993

[Primary malignant lymphoma in the appendix vermiformis].

Primary gastrointestinal lymphoma (PGL) is a rare condition. A case story concerning a 17 year old boy is presented and discussed. The symptoms were fever and pain in the lower right quadrant of the abdomen, where a tender tumor was palpable. The tentative diagnosis was periappendicular abscess and the patient was treated with antibiotics. As the tumor persisted, a laparotomy with resection of the coecum was performed. Histologic diagnosis was malignant lymphoma originating in the appendix. There was no sign of dissemination in the abdomen. Postoperative treatment with chemotherapy and radiation was carried out. PGL in the appendix in young patients, almost entirely males, will as here often be of the Burkitt type. The histologic type of the tumor, the staging and the radicality at operation are important with regard to prognosis.

Adolescent↗

PubMed1993

[Carcinoid tumors of the appendix. Review of the literature and two case reports].

Gastrointestinal carcinoids are infrequent but at the same time hardly rare tumours. They are often chance findings but, as is clearly reported in the literature, their potential malignancy should not be overlooked. They are most commonly localised in the appendix. The authors describe two case reports of carcinoid tumours of the appendix, one of which was diagnosed during left hemicolectomy due to Crohn's disease and the other during acute appendicitis. Prognostic and therapeutic problems are discussed in the light of the most recent literature.

Adult↗

PubMed1996

[Adenocarcinoma of the appendix. A propos of a case complicated by double local and parietal recurrence].

Adenocarcinoma of the appendix is rarely encountered and is usually discovered fortuitously at pathology examination of the surgical specimen. Six years after surgery for degenerative villous tumor of the appendix, local and parietal recurrence led to surgery in our patient. We present here the indications for complementary hemicolectomy and management of parietal scars resulting from the initial appendectomy.

Adenocarcinoma, Mucinous↗

PubMed1997

Lymphoma of the appendix. A case report.

Lymphoma of the appendix is exceptionally rare and the management of this condition is still controversial. A multimodality approach (surgery, radiation therapy, chemotherapy) is the optimal treatment. The Authors report a case of lymphoma of the appendix treated by right hemicolectomy and postoperative multiagent chemotherapy.

Antibiotics, Antineoplastic↗

PubMed1997

Mucin deposits within inguinal hernia sacs: a presenting finding of low-grade mucinous cystic tumors of the appendix. A report of two cases and a review of the literature.

Two male patients, both 41 years of age, presented clinically with a typical inguinal hernia. The herniorrhaphy specimens were found on routine pathologic examination to contain abundant mucin that was focally organizing and was devoid of associated epithelial cells. Both cases were seen in consultation because of uncertainty as to the nature of the process. The possibility that the mucin might represent spread from an appendiceal mucinous cystic tumor led to the investigation of the appendix and in both cases such a tumor was discovered. The widespread involvement of the peritoneum that is characteristic of pseudomyxoma peritonei was absent in each case. These cases represent one of the many "surprise" findings that may be encountered in hernia sac specimens and one of the many problematic pathologic manifestations that may be associated with low-grade mucinous neoplasms of the appendix. Although this phenomenon is described in the literature, experience with our two cases indicates that it may still pose a significant diagnostic challenge.

Adult↗

PubMedDate not supplied

Secretoneurin in carcinoids of the appendix-immunohistochemical comparison with chromogranins A,B and secretogranin II.

BACKGROUND: The aim of the present study was to investigate immunohistochemically the distribution of secretoneurin, a novel 33 amino acid peptide, in comparison to chromogranin A, chromogranin B, and secretogranin II in carcinoids of the appendix. MATERIALS AND METHODS: Paraffin-embedded tissues from 47 carcinoids were incubated with antibodies specific for chromogranin A, chromogranin B, the secretogranin II derived peptide LF- 19, and secretoneurin. RESULTS: 44 tumors (94%) were positive for secretoneurin, whereas only 39 tumors (83%) were immunoreactive for chromogranin A. There was no significant correlation between neuropeptide expression and type of carcinoid, tumor size, vascular infiltration, serosal involvement or mesoappendiceal infiltration. CONCLUSIONS: Our investigations revealed that secretoneurin is detected more frequently than chromogranin A in carcinoids of the appendix. This supports the theory that tumor cells of appendiceal carcinoids are of a different origin than other midgut carcinoids. No special tumor entity with a characteristic secretoneurin-chromogranin pattern could be identified.

Antigens, CD↗

PubMed1979

Porcelain appendix. A calcified mucocele fractures to produce an acute abdomen.

Mucocele of the appendix is rare and occasionally is accompanied by calcification. In a recent case, an eggshell-thin calcified mucocele fractured to produce an acute abdomen. This situation was not found in a review of the literature. A brief summary of the properties of mucocele is presented.

Abdomen, Acute↗

PubMed1992

The 'absent' appendix.

During an operation for suspected appendicitis, the surgeon concluded that the appendix was absent. The causes of this situation are presented and a guide to its management is suggested.

Abdominal Pain↗

PubMed1988

Sex, Enterobius vermicularis and the appendix.

Examination of 182 appendices containing Enterobius vermicularis demonstrated that male pinworms are seen more commonly than female. There was no association between the sex of pinworms and inflammation in the appendix but inflammation was frequently seen in association with luminal ova. Ova release from female pinworms may be a feature of appendiceal obstruction.

Acute Disease↗

PubMed1991

Schistosomiasis of the appendix.

The clinicopathological features of schistosomiasis of the appendix are discussed, based on the clinical presentation, operative findings and morphological changes in the specimens of patients seen in Ibadan between 1980 and 1989. Schistosoma haematobium was implicated as the causal agent of a granulomatous inflammatory reaction with eosinophilia and fibrosis. Intramuscular oviposition was associated with frank acute appendicitis, and serosal involvement resulted in peritoneal adhesions, with ileoileal intussusception in one patient. The actual role of schistosomal infestation as a contributory factor in appendicitis is still open to debate, but the diagnosis must be entertained in patients in the tropics with features of acute appendicitis or recurrent abdominal pain.

Adult↗

PubMed1977

Retropenal abcess secondary to a ruptured retrocecal appendix diagnosed by ultrasound B scan and 67 Ga radionulide scan.

Standard roentgenographic criteria for anterior-posterior (AP) displacement of the kidney may not reveal small, uniformly distributed, perirenal masses. Ultrasound, on the other hand, is an axial display and thus is quite sensitive to such changes. A case of ruptured retrocecal appendix is presented in which the intravenous pyelogram was negative. In the sonogram, however, a slight separation was seen between the renal parenchyma and the posterior abdominal muscle wall. This led to further investigation and the diagnosis of an unsuspected retrorenal abscess.

Abdomen↗

PubMed1980

Lymphocyte positions in the dome epithelium of the rabbit appendix.

The apico-basal distribution of lymphocytes within the epithelium covering the domes of lymphatic tissue in the wall of the rabbit appendix was investigated in single and serial sections stained either for general histology, for cytoplasmic basophilia and acidophilia, or for nonspecific esterase activity. From the base to the summit of a dome, four zones numbered proximo-distally 1-4 were distinguished. Epithelial cells migrate from base to summit, as indicated by mitotic figures in zone 1, the gradual change from cytoplasmic basophilia to acidophilia in zones 2 to 4, and visible extrusion of cells from zone 4 at the summit. Zone 1 was free of lymphocytes. Most of the lymphocytes in zone 2 were intercellular and randomly arranged, but a few in this zone were within tapered epithelial cells modified by a process extending basally to the basement membrane. Small numbers of these tapered epithelial cells also occurred in zone 3. The large clusters of ten to 12 lymphocytes that characterized zone 3 were intercellular and impinged the apical regions of epithelial cells. Serial sections at the level of the distal cluster of zone 3 showed lymphocytes located also more basally, and some of these lymphocytes appeared to be passing through the basement membrane back into the lymphoid tissue of the dome. Epithelium of zone 4 over the distal surface of a dome was largely free of lymphocytes. Apparently most infiltrating lymphocytes form intercellular clusters and then return to the subepithelial lymphatic tissue.

Animals↗

PubMed1982

"Extraepithelial enterochromaffin cell--nerve-fibre complexes" in the normal human appendix, and in neurogenic appendicopathy.

Extraepithelial, extraglandular endocrine cells of types EC1 and EC2 occur in the lamina propria of the normal appendix. They are more numerous in intramucosal neurogenic appendicopathy. Ultrastructurally there is invariably a close association between the cells and non-myelinated nerve fibres of the mucous plexus. Together they form a complex surrounded by a common basal lamina, and the term enterochromaffin cell-nerve fibre complex (ECC-NF) is suggested for this morphological and functional unit. The derivation of extraepithelial EC cells from the glandular epithelial cells could not be established and the existence of the complexes is held to support an origin from neuroendocrine-programmed ectoblasts.

Adolescent↗

PubMed1991

The topographical and age distributions of neuroendocrine cells in the normal human appendix.

In order to clarify the histogenesis of appendiceal carcinoid tumours, epithelial (ENC) and subepithelial (SNC) neuroendocrine cells were counted at four sites in 50 normal appendices stained by standard argyrophil and argentaffin techniques. In general, ENC were present in similar number at all sites within the appendix, whereas SNC were more numerous at the tip than at the base. The number of ENC was similar throughout life, apart from an increase in one neonate and some elderly patients, whereas SNC were maximal in young adults. Thus, the topographical and age distributions of SNC, but not those of ENC, parallels the topographical and age incidence of appendiceal carcinoid tumours, suggesting that most appendiceal carcinoid tumours arise from SNC rather than ENC.

Adolescent↗

PubMed1998

B-cell superantigens may play a role in B-cell development and selection in the young rabbit appendix.

In order to develop protective antibodies against a wide range of potentially infectious pathogens, the young rabbit must diversify a limited initial repertoire by somatic mechanisms (the high copy number primary repertoire). The majority of rabbit B cells produce heavy chain variable regions by rearranging the VHa allotype-encoding VH1 gene. Thus in normal rabbits the majority of serum immunoglobulins bear VHa allotype (due to VH1 FR1 and FR3 sequences). The young rabbit appendix is a site of diversification of rearranged VH genes by gene-conversion-like and somatic hypermutation mechanisms. The newly generated B cells probably undergo selection processes that involve foreign and self-antigens and superantigens. We find preferential expansion and survival of B cells in normal and VH-mutant ali/ali rabbits based on their heavy chain FR1 and FR3 sequences (VHa allotype). This selection may involve "superantigen"-like interactions with endogenous as well as exogenous ligands.

Amino Acid Sequence↗

PubMed1993

Identification of M cells and their distribution in rabbit intestinal Peyer's patches and appendix.

The distribution of intestinal membranous (M) cells has been studied within the follicle-associated epithelium of rabbit Peyer's patches and appendix. Vimentin expression has been assessed as a primary criterion to identify rabbit M cells in tissue sections and in whole tissue preparations. This criterion has been compared to the use of the absence of alkaline phosphatase which, due to its heterogeneous distribution within the enterocyte population, is less reliable than vimentin expression as a marker for rabbit M cells. The pattern of vimentin immunostaining revealed that the majority of M cells are located in the periphery of the follicle-associated epithelium, the dome apex being largely free of M cells. This distribution was confirmed by scanning electron microscopy. Vimentin is also expressed by follicle-associated epithelial cells in the vicinity of crypts which lack the typical lymphocyte-containing pocket of M cells. Cytoplasmic peanut agglutinin binding coincides with vimentin-expression throughout the follicle-associated epithelium but is absent from vimentin-negative enterocytes. The co-localisation of these two phenotypic markers in both M cells and epithelial cells adjacent to crypts, which lack the typical morphology of fully developed rabbit M cells, suggests that they correspond to immature M cells which by their location appear to derive directly from undifferentiated crypt stem cells and not from mature columnar enterocytes.

Alkaline Phosphatase↗

PubMed1989

Penetration of clindamycin and metronidazole into the appendix and peritoneal fluid in children.

Thirty-one children underwent appendectomy following administration of a single i.v. dose of clindamycin 10 mg/kg or metronidazole 7.5 mg/kg. The serum levels of the antibiotics at that time were comparable, but the tissue concentration of clindamycin in the appendix (mean 7.23 micrograms/g) exceeded that of metronidazole (mean 2.27 micrograms/g). The concurrent mean concentration of metronidazole in peritoneal fluid (14.26 micrograms/ml) was higher than that of clindamycin (7.72 micrograms/ml).

Appendix↗

PubMed1994

A case of Crohn's disease limited to the appendix, showing a portentous ultrasonographic finding.

A case of Crohn's disease limited to the appendix is reported. A preoperative ultrasonic study of the lower right abdomen revealed an interesting appearance that we named the "milky way sign." Microscopic findings in the resected specimen confirmed that the sign represented adipose tissue of the mesoappendix that had become involved by transmural inflammation. This seems to be highly suggestive of Crohn's disease.

Adipose Tissue↗