Difference between revisions of "Appendix"
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==Gross processing== | ==Gross processing== | ||
{{Gross processing}} | {{Gross processing}} | ||
+ | *Measure the length of the appendix.<ref name=lilla>{{Lilla utskärningen}}</ref> | ||
+ | *Note its shape and thickness<ref name=lilla/> | ||
+ | *Cut off about 1.5 cm from the tip and split it in half long the lumen. Divide the remainder into about 3-5 mm thick transverse slices.<ref name=lilla/> | ||
+ | *Look mainly for:<ref name=lilla/> | ||
+ | :*Luminal pus or obstruction, including stones. Carcinoids may hide behind obstructions in the tip. | ||
+ | :*Wall defects | ||
+ | :*Exterior coatings. Note if it contains "stones" or fruit kernels. | ||
+ | *Submit:<ref name=lilla/> | ||
+ | :*At least one half of the tip | ||
+ | :*A transverse slice closest to the base, that is, the surgical cut. | ||
+ | :*At least one transverse slice from an intermediate part. | ||
+ | Particular findings indicating sampling include:<ref name=lilla/> | ||
+ | *Wall discoloration | ||
+ | *External green-gray-yellow coating | ||
+ | *Suspected wall defects | ||
+ | |||
==Microscopic evaluation== | ==Microscopic evaluation== | ||
[[File:Appendix neoplasms by incidence and prognosis.png|thumb|Appendix neoplasms by incidence and prognosis.]] | [[File:Appendix neoplasms by incidence and prognosis.png|thumb|Appendix neoplasms by incidence and prognosis.]] |
Revision as of 11:39, 21 January 2020
Author:
Mikael Häggström [note 1]
Contents
Fixation
Generally 10% neutral buffered formalin.
See also: General notes on fixation
Gross processing
See also: General notes on gross processing
- Measure the length of the appendix.[1]
- Note its shape and thickness[1]
- Cut off about 1.5 cm from the tip and split it in half long the lumen. Divide the remainder into about 3-5 mm thick transverse slices.[1]
- Look mainly for:[1]
- Luminal pus or obstruction, including stones. Carcinoids may hide behind obstructions in the tip.
- Wall defects
- Exterior coatings. Note if it contains "stones" or fruit kernels.
- Submit:[1]
- At least one half of the tip
- A transverse slice closest to the base, that is, the surgical cut.
- At least one transverse slice from an intermediate part.
Particular findings indicating sampling include:[1]
- Wall discoloration
- External green-gray-yellow coating
- Suspected wall defects
Microscopic evaluation
- Look for cancerous cells (also for specimens with clinical appendicitis).
Appendiceal carcinoid. The arrow points out a cluster of neuroendocrine cells. There are also inflammatory cells consistent with acute appendicitis.[2]
Low-grade appendiceal mucinous neoplasm: Minimal cytological atypia of the epithelial cells.[3]
Report
- Description of objective findings.
- Presence or absence of malignancy.
See also: General notes on reporting
Notes
- ↑ For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Patholines:Authorship for details.
Main page
References
- ↑ 1.0 1.1 1.2 1.3 1.4 1.5 Monica Dahlgren, Janne Malina, Anna Måsbäck, Otto Ljungberg (1997-02-13). Lilla utskärningen.
- ↑ Elkbuli, Adel; Sanchez, Carol; McKenney, Mark; Boneva, Dessy (2019). "Incidental neuro-endocrine tumor of the appendix: Case report and literature review ". Annals of Medicine and Surgery 43: 44–47. doi: . ISSN 20490801.
- ↑ Hajjar, Roy; Dubé, Pierre; Mitchell, Andrew; Sidéris, Lucas (2019). "Combined Mucinous and Neuroendocrine Tumours of the Appendix Managed with Surgical Cytoreduction and Oxaliplatin-based Hyperthermic Intraperitoneal Chemotherapy ". Cureus. doi: . ISSN 2168-8184.
Image sources