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PubMed1999

Sonographic detection of normal and abnormal appendix.

AIM: The aim of the study was to assess the value of sonography in detecting the normal appendix and in identifying abnormality. METHODS: The appendiceal wall thickness (normal: <3 mm) and ultraluminal contents (abnormal: large appendicolith, non-expressible fluid) were used as the primary criteria to determine the appendiceal status in 716 appendices. In patients who underwent appendicectomy (n = 166), surgical and histopathological findings were correlated with the ultrasound (US) findings; in patients who did not have surgery the reference standard was the clinical consensus based on follow-up. RESULTS: Thirty-four patients out of 179 with abnormal sonographic findings did not undergo appendicectomy and recovered spontaneously; in 22 of these, the US changes were confined to the appendiceal tip. A normal appendix was identified in 537 patients (45.9% of all patients without appendicitis), with histologic verification subsequently obtained in 21. In 76 normal appendices (14.2% out of all normal appendices), luminal dilatation due to non-expressible inspissated faeces resulted in appendiceal outer diameter >6 mm (range, 6.2-12 mm); a histopathologic proof of non-inflamed appendix was obtained in seven of these. CONCLUSIONS: A normal appendix can be visualized in a high percentage of cases and it may present with an outer diameter >6 mm (the widely-accepted upper limit of normal) due to the inspissated faecal material within the lumen. A significant percentage of early appendicitis can resolve spontaneously, especially when confined to the appendiceal tip.

Acute Disease↗
PubMed1998

Multifocal neoplasia involving the colon and appendix in ulcerative colitis: pathological and molecular features.

A patient with ulcerative colitis, extensive dysplasia, multifocal colon cancer, and an appendiceal cystadenoma is described. A 48-year-old man with a 26-year history of ulcerative colitis (UC) had extensive dysplasia involving nearly the entire colon and four dysplasia-associated mass lesions (DALMs). Four invasive adenocarcinomas were present. This case is the first documentation of a DALM (mucinous cystadenoma) arising in the appendix in the setting of UC. The genetic alterations present in the various lesions were analyzed. The molecular profiles of the neoplastic lesions differed. Mutations were found in p53 and ras genes, and one site showed microsatellite instability in a single genetic locus. These molecular abnormalities develop before invasive cancer develops, and may undergo clonal expansion to create large mucosal patches containing certain cells with genetic alterations. The diversity of the early changes suggests that the recurrent inflammation characteristic of long-standing UC randomly damages genes known to participate in colon carcinogenesis and that it affects multiple target genes. The findings also support a multiclonal origin of synchronous tumors because the molecular phenotypes of the preinvasive lesions differed at various sites.

Appendiceal Neoplasms↗
PubMed1976

Pseudolymphoma presenting as a cecal tumor.

A 7-yr-old with abdominal pain and melena had a barium enema which revealed a cecal lesion that proved to be a pseudolymphoma of the cecum and appendix--a site not previously reported.

Appendiceal Neoplasms↗
PubMed1980

Epidermoid cyst of the appendix.

Epidermoids cyst of the abdominal viscera is an uncommon condition. Cases have been reported involving the spleen, kidneys, gonads, fallopian tubes, uterus, mesentery, and cecum (mice). An epidermoid cyst of the vermiform appendix is presented.

Appendiceal Neoplasms↗
PubMed1998

Adenocarcinoma of the appendix in a child.

Adenocarcinoma of the appendix is unusual at any age but occurs mostly in an elderly population. The authors report a unique case presenting in a 10-year-old child and emphasize the importance of subjecting all resected specimens to histological examination.

Abdomen, Acute↗
PubMed1991

Appendiceal carcinoma masquerading as primary bladder carcinoma.

We report 2 cases of appendiceal adenocarcinoma invading the bladder. Both tumors masqueraded as primary bladder carcinomas. Cystoscopic biopsies obtained adenocarcinomatous tissue and the secondary nature of the bladder lesion became apparent at laparotomy in both cases. One patient was treated with surgical resection of the appendix, the adjacent cecal wall and the bladder wall, and postoperative irradiation. She was well 10 years later. The other patient was treated with right colectomy and segmental bladder resection. She died of diffuse peritoneal recurrence 6 years later.

Adenocarcinoma, Mucinous↗
PubMed1980

Adenocarcinoma of the appendix penetrating the bladder.

We report a case of a mucous papillary tumor in the bladder. Initial treatment was transurethral resection but open partial bladder resection became necessary. Operation revealed an appendix tumor penetrating the bladder. Histologically, it was primary adenocarcinoma of the appendix.

Adenocarcinoma, Papillary↗