Difference between revisions of "Appendicitis"
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m (→Microscopic evaluation: Delinked) |
(→Microscopic evaluation: Bolded) |
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! Acute intraluminal inflammation | ! Acute intraluminal inflammation | ||
| None visible || | | None visible || | ||
− | *Only neutrophils in lumen | + | *Only '''neutrophils in lumen''' |
*No ulceration or transmural inflammation | *No ulceration or transmural inflammation | ||
| Probably none | | Probably none | ||
Line 36: | Line 36: | ||
! Acute mucosal inflammation | ! Acute mucosal inflammation | ||
| None visible || | | None visible || | ||
− | *Neutrophils within mucosa, and possibly in submucosa | + | *'''Neutrophils within mucosa''', and possibly in submucosa |
− | *Mucosal ulceration | + | *Mucosal '''ulceration''' |
| May be secondary to [[enteritis]]. | | May be secondary to [[enteritis]]. | ||
|- | |- | ||
! Suppurative acute appendicitis | ! Suppurative acute appendicitis | ||
| May be inapparent. | | May be inapparent. | ||
− | *Dull mucosa | + | *'''Dull''' mucosa |
− | * | + | *'''Congestion''' of surface vessels |
− | *Fibropurulent serosal exudate in late cases | + | *Fibropurulent serosal '''exudate''' in late cases |
− | * | + | *'''Dilation''' of the appendix |
| | | | ||
− | *Neutrophils in mucosa, submucosa and muscularis propria, potentially transmural. | + | *Neutrophils in mucosa, submucosa and muscularis propria, potentially '''transmural'''. |
− | *Extensive inflammation | + | *'''Extensive inflammation''' |
− | *Commonly intramural abscesses | + | *Commonly intramural '''abscesses''' |
− | *Possibly vascular thrombosis | + | *Possibly vascular '''thrombosis''' |
| Can be presumed to be primary cause of symptoms | | Can be presumed to be primary cause of symptoms | ||
|- | |- | ||
Line 58: | Line 58: | ||
*Purple, green or black color | *Purple, green or black color | ||
| | | | ||
− | *Transmural inflammation | + | *'''Transmural''' inflammation |
− | *Necrotic areas | + | *'''Necrotic''' areas |
− | *Extensive mucosal ulceration | + | *Extensive mucosal '''ulceration''' |
| Will perforate if untreated | | Will perforate if untreated | ||
|- | |- | ||
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*Serosa may be congested, dull and exudative | *Serosa may be congested, dull and exudative | ||
| | | | ||
− | *Serosal and subserosal inflammation, no further than outer muscularis propria | + | *'''Serosal and subserosal inflammation''', no further than outer muscularis propria |
| If isolated, probably secondary to other disease | | If isolated, probably secondary to other disease | ||
|- | |- | ||
Line 73: | Line 73: | ||
| None visible | | None visible | ||
| | | | ||
− | *>10 eosinophils/mm<sup>2</sup> in muscularis propria. | + | *>10 '''eosinophils'''/mm<sup>2</sup> in muscularis propria. |
*No changes conforming to other types of appendicitis | *No changes conforming to other types of appendicitis | ||
| Possibly parasitic, or eosinophilic enteritis. | | Possibly parasitic, or eosinophilic enteritis. | ||
Line 81: | Line 81: | ||
*Fibrosis | *Fibrosis | ||
| | | | ||
− | *Predominantly mononuclear infiltrate rather than neutrophilic. | + | *Predominantly '''mononuclear''' infiltrate rather than neutrophilic. |
| Should preferably correlate with long-term or recurrent symptoms. | | Should preferably correlate with long-term or recurrent symptoms. | ||
|} | |} |
Revision as of 13:42, 9 September 2020
Author:
Mikael Häggström [note 1]
Appendicitis may histopathologically be defined as neutrophilic infiltrates of the wall of the appendix in the correct clinical context.
See also: General notes on fixation
Contents
Comprehensiveness
Comprehensiveness
On this resource, the following formatting is used for comprehensiveness:
- Minimal depth
- (Moderate depth)
- ((Comprehensive))
Gross proccessing
Standard sections if the appendix appears inflamed and there are no signs of malignancy. Further information: Appendix
Microscopic evaluation
- Evaluate depth of the inflammation.
- Look for any perforation of the wall.
- Look for cancerous cells (which may have caused the appendicitis). Further information: Appendix
- (Attempt to specify the type of appendicitis as either of the following:)
Types
Pattern | Gross pathology | Light microscopy | Clinical significance |
---|---|---|---|
Acute intraluminal inflammation | None visible |
|
Probably none |
Acute mucosal inflammation | None visible |
|
May be secondary to enteritis. |
Suppurative acute appendicitis | May be inapparent.
|
|
Can be presumed to be primary cause of symptoms |
Gangrenous/necrotizing appendicitis |
|
|
Will perforate if untreated |
Periappendicitis | May be inapparent.
|
|
If isolated, probably secondary to other disease |
Eosinophilic appendicitis | None visible |
|
Possibly parasitic, or eosinophilic enteritis. |
Chronic appendicitis[2] |
|
|
Should preferably correlate with long-term or recurrent symptoms. |
Microscopy report
Should include, if detected:
- Acute or chronic appendicitis
- Depth of inflammation
- Any abscess and\or perforation
- Necrosis and\or ulceration, at least if transmural
(Classification into one or several types as per table above.)
- Example
Acute appendicitis and periappendicitis with transmural necrosis
Notes
Main pageReferences
Image sources
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