Abstract
Introduction: Acute eosinophilic appendicitis (AEA) is a rare variant of inflammation of the appendix. The histologic hallmark of this entity is the infiltration of eosinophils in the musularis layer of the appendix with edema separating the muscle fibers with very few or no neutrophilic infiltration. A retrospective study was done to determine their demographic profile, morphological diagnosis, and clinical correlation. Materials and Methods: All cases of Acute appendicitis reported at the histopathology department of Sri Muthukumaran Medical College and Research Institute, a teaching hospital from the year of Jan 2017 to Dec 2019 were included in this study. Histopathological examination is the gold standard for the diagnosis of acute appendicitis. Hence, Formalin-fixed paraffin-embedded tissue which was stained with Hematoxylin and Eosin were retrieved and used for routine morphology and diagnosis. Results: Out of 419 cases of appendicectomies studied, 27 (6.49%) cases were found to be acute eosinophilic appendicitis, 265 (63.7%) cases were acute appendicitis, 30 (7.2%) cases were reported as acute suppurative appendicitis with periappendicitis most of which showed infiltration of eosinophils along with other inflammatory cells and 97 (23.3%) cases were reported as appendix with reactive lymphoid hyperplasia. Most of the acute appendicitis showed gross edema and congested blood vessels on the serosal surface. Enterobius vermicularis worm infestation was noted in 7 (25%) cases reported as acute eosinophilic appendicitis and in 20 (7.5%) cases of acute appendicitis. Conclusion: It was inferred that the acute eosinophilic appendicitis is a condition which could be an allergic response and an early event in the evolution of acute phlegmonous appendicitis.
Highlights
Acute eosinophilic appendicitis (AEA) is a rare variant of inflammation of the appendix
Materials and Methods: All cases of Acute appendicitis reported at the histopathology department of Sri Muthukumaran Medical College and Research Institute, a teaching hospital from the year of Jan 2017 to Dec 2019 were included in this study
Out of 419 cases of appendicectomies studied, 27 (6.49%) cases were found to be acute eosinophilic appendicitis, 265 (63.7%) cases were acute appendicitis, 30 (7.2%) cases were reported as acute suppurative appendicitis with periappendicitis most of which showed infiltration of eosinophils along with other inflammatory cells and 97 (23.3%) cases were reported as appendix with reactive lymphoid hyperplasia
Summary
Acute eosinophilic appendicitis (AEA) is a rare variant of inflammation of the appendix. The histologic hallmark of this entity is the infiltration of eosinophils in the musularis layer of the appendix with edema separating the muscle fibers with very few or no neutrophilic infiltration. Acute eosinophilic appendicitis (AEA) is a rare clinical entity that is characterized clinically by acute abdominal pain and a grossly inflamed appendix with few or absence of neutrophils in the muscle layer microscopically. The histologic hallmark of Acute eosinophilic appendicitis is eosinophilic infiltration of the muscularis propria with accompanying edema separating the muscle fibers. The diagnosis of classic suppurative appendicitis (phlegmonous appendicitis) should be made only in the presence of neutrophils in the muscularis propria [1]. There are very few studies with respect to the observation of eosinophilic infiltration of the muscularis propria in the absence of any other abnormality [4,5]
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