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Research Papers

Unexpected pathological lesions of appendix: an analysis of 3000 surgical specimens from Sri Lanka

Authors:

D.L.P. Dasanayake,

Department of Pathology, Faculty of Medicine, University of Peradeniya, LK
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Sulochana Wijetunge ,

Department of Pathology, Faculty of Medicine, University of Peradeniya, LK
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K. Dharani,

Department of Pathology, Faculty of Medicine, University of Peradeniya, LK
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D.N.K. Bowala,

Department of Pathology, Faculty of Medicine, University of Peradeniya, LK
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N.V.I. Ratnatunga

Department of Pathology, Faculty of Medicine, University of Peradeniya, LK
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Abstract

Background: Unexpected pathological lesions are not infrequent findings in surgical specimens of appendix. Appendiceal malignancies are commonly encountered as incidental lesions.

Objective: To analyze the unexpected appendiceal pathological lesions encountered in surgical specimens in a sample of Sri Lankan patients.

Methods: A retrospective review of 3000 consecutive appendicectomy specimens and appendices in colectomy specimens received at the Department of Pathology, Faculty of Medicine, University of Peradeniya from 2001 to 2014.

Results: There were 2907 appendicectomy specimens and 93 colectomy specimens with an appendix. In appendicectomy specimens, there were 9 (0.3%) primary neoplasms of which 8 were malignant, 2 (0.06%) secondary carcinoma deposits, 7 (0.24%) endometriosis, 7 (0.24%) granulomatous inflammation, 2010 (69.1%) acute appendicitis and the rest (30%) were unremarkable. In the appendices of colectomy specimens, there were 4 (4.3%) primary neoplasms, all of which were malignant, 7 (7.5%) secondary carcinoma deposits, 1 (1.1%) granulomatous inflammation, 11 (11.8%) acute appendicitis and the rest (75.2%) were unremarkable. Of the 3000 specimens, 13 (0.4%) had a primary appendiceal neoplasm: 9 (0.3%) mucinous neoplasms, 3 (0.1%) NET G1 (carcinoids) and 1 (0.03%) sessile serrated adenoma. Of the mucinous neoplasms, 1 was an adenoma, 3 were low grade appendiceal mucinous neoplasms and 5 were adenocarcinomas. Caseous tuberculoid granulomata were present in 5/8 (62.5%) granulomatous appendicitis.

Conclusions: The commonest unexpected finding in the appendicectomy sample was primary malignant tumours (0.3%) and the commonest malignant tumour group was mucinous neoplasms. Secondary adenocarcinoma is the commonest pathology in the appendices of colectomy specimens. Most granulomatous appendicitis cases were suggestive of tuberculosis.

How to Cite: Dasanayake, D.L.P. et al., (2016). Unexpected pathological lesions of appendix: an analysis of 3000 surgical specimens from Sri Lanka. Sri Lanka Journal of Medicine. 24(1), pp.4–11. DOI: http://doi.org/10.4038/sljm.v24i1.2
Published on 09 May 2016.
Peer Reviewed

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