A Postmortem Study of the Number of Germinal Centers in the Vermiform Appendix of Bangladeshi People in Different Age Groups

Abstract

Appendicitis is the most common clinical condition of the appendix and is the most common acute abdominal surgical emergency. In 60% of patients, appendicitis is due to obstruction of the lumen of the appendix by hyperplasia of the intramural lymphoid follicles. This form of obstruction is mostly observed in children. The incidence of appendicitis coincides very well with the number of lymphoid follicles. Germinal centers are sites within lymphoid follicles in peripheral lymphoid tissues where mature B lymphocytes rapidly proliferate, differentiate and mutate their antibodies and class switches their antibodies during a normal immune response to an infection. Presence of germinal centers reflects state of activity of the immune system of the body. In Bangladesh there is no data regarding number of germinal centers of lymphoid follicles of the vermiform appendix. The present study is aimed to observe the number of germinal centers of the lymphoid follicles of the vermiform appendix in various age groups. With this aim the present study was carried out in the department of Anatomy, Sir Salimullah Medical College, Dhaka, from January 2008 to June 2009. After taking approval from the Institutional Ethics Committee sixty (60) postmortem vermiform appendices of different age groups collected by convenient sampling from unclaimed dead bodies of Bangladeshi cadavers which were under autopsy examination in the Department of Forensic Medicine of Dhaka Medical College (DMC) and Sir Salimullah Medical College (SSMC), Dhaka,. The average number of germinal centers of the lymphoid follicle per histological section of vermiform appendix reduced with advancing age and showed a significant negative correlation with age (p < 0.001). In the present study, the number of germinal centers of the lymphoid follicles of the vermiform appendix reduced significantly with advancing age.