Unusual Incidental Pathological Findings of The Appendix Histopathological and Immunohistochemical Study

Abstract

Background and Objective: Acute appendicitis is one of the most common surgical emergencies. Incidental appendiceal findings without any prior clinical or radiological diagnosis are still challenging. Histopathological diagnosis can help in avoiding further complications for patient safety. Methods: A retrospective study of 504 resected appendices done in Al Emadi Hospital Doha, Qatar, during the four years from January 2016 to December 2019 and diagnosed as appendicitis underwent pathological examination that revealed confirm appendicitis in 471 (93.5%) cases while 33 (6.5%) of cases showed unusual pathological findings that did not detect either clinically or radiologically. Results: Out of 504 specimens of the appendix, appendicitis accounted for 93.5% with peak occurrence at the age group of 20 to 40 years and female predominance. Suppurative appendicitis (47.8%) was the most common findings. It was found an incidental finding in 33 (6.5%) cases, 21 (4.1%) cases were appendicitis obliterans, three (0.6%) cases were a well-differentiated neuroendocrine tumor, three (0.6%) cases were low grade appendiceal mucinous neoplasm, three (0.6%) cases were diverticulosis, two (0.4%) cases were granuloma of the appendix and one (0.2%) case was diagnosed as eosinophilic appendicitis. Conclusion: Routine histopathological examination of appendectomy specimens is of value to discover unusual pathologies that require further postoperative management. Gross examination alone is not a good indicator of an unexpected finding.