Unusual incidental findings of routine histopathological examination of appendectomy specimens- a 2-year retrospective analysis with review of the literature

Abstract

Objective

To review the diagnosis of all patients that underwent appendectomy at our institute over a period of 2 years, and to correlate the histopathological diagnosis with the clinical diagnosis in each case.

Material and methods

This was a 2 year retrospective study including all patients that presented to our institute with acute appendicitis and underwent appendectomy for the same, over the period of 2 years. Cases that underwent appendectomies as an incidental procedure during some other operation were excluded.

Results

A total of 325 cases were included in our study. Majority of these cases (300/325, 92.3%) showed features of appendicitis (acute, subacute, chronic, recurrent or resolving). 17 (5.2%) of the cases were labeled as normal while the remaining cases (8/325, 2.5%) had some unexpected abnormal findings including 2 cases of mucocele and 1 case each of granulomatous appendicitis, eosinophilic obliterative appendicitis, well differentiated mucinous cystadenocarcinoma, well differentiated adenocarcinoma, carcinoid and low grade appendiceal mucinous neoplasm with pseudomyxoma peritonei.

Conclusion

Though majority of cases had the usual features, a few of these had important incidental diagnoses which were not suspected preoperatively or even intraoperatively by the surgeon. These findings support the opinion that all appendectomy specimens should be routinely sent for histopathological examination, which is unfortunately not the scenario in many centers across India.