Histopathological Spectrum of Appendicular Lesions: A Cross-sectional Study

Abstract

Introduction: Multiple pathologies, ranging from non neoplastic to neoplastic tumours that may or may not obstruct the lumen, might result in appendicitis. Uncommon neoplastic appendix lesions show diverse morphologies, resembling adenomas to colorectal carcinoma. Identifying these traits is vital to differentiate them from non neoplastic mucinous lesions, as they require varied management approaches, including followup and chemotherapy. Aim: To assess the histopathological patterns in patients undergoing appendicectomy and to study the detailed morphological features of different non neoplastic and neoplastic lesions. Materials and Methods: This cross-sectional study was conducted in western part of Maharashtra for 3 years. It involved surgically removed specimens of appendix received for histopathological evaluation of the appendix from January 2019 to December 2022. A detailed gross examination of the appendicectomy specimens was carried out. Data were analysed using Statistical Package for the Social Sciences (SPSS) software, version 22.0. Categorical data such as sex, clinical presentation, gross presentation of the appendix, and histopathological findings were presented as n (%), whereas quantitative data such as age were presented as mean±SD. A p-value<0.05 was considered statistically significant. Results: A total of 716 patients were included in this study. The median age of the patients was 25.0 years. The majority of the population belonged to the 21-45 years age group, with 406 (56.7%) patients. The number of males were higher 236 (32.9%) than females 170 (23.4%). The number of patients with inflammatory or non neoplastic lesions was higher than those with neoplastic lesions, with 709 (99.02%) and 7 (0.98%) respectively. The highest number of patients had chronic appendicitis (284;39.66%), followed by acute on chronic appendicitis (216;30.16%) and acute appendicitis (188; 26.25%). Conclusion: In cases of appendicitis, histopathological examination of the appendix should be performed as it provides crucial clinical information in addition to operative findings. Hence, it is a benchmark in diagnosing acute appendicitis.