Chronic appendicitis: Difference between revisions
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Chronic [[appendicitis]]: | Chronic [[appendicitis]] (including peri-appendicitis): | ||
{{Fixation - standard}} | {{Fixation - standard}} | ||
{{Fixation - general notes}} | {{Fixation - general notes}} | ||
{{Comprehensiveness}} | |||
==Gross processing== | ==Gross processing== | ||
{{Further|Appendix}} | {{Further|Appendix}} | ||
A major clue to chronic appendicitis is fibrosis.<ref name="SierakowskiPattichis2016">{{cite journal|last1=Sierakowski|first1=Kyra|last2=Pattichis|first2=Andrew|last3=Russell|first3=Patrick|last4=Wattchow|first4=David|title=Unusual presentation of a familiar pathology: chronic appendicitis|journal=BMJ Case Reports|year=2016|pages=bcr2015212485|issn=1757-790X|doi=10.1136/bcr-2015-212485}}</ref> | A major visual clue to chronic appendicitis is fibrosis.<ref name="SierakowskiPattichis2016">{{cite journal|last1=Sierakowski|first1=Kyra|last2=Pattichis|first2=Andrew|last3=Russell|first3=Patrick|last4=Wattchow|first4=David|title=Unusual presentation of a familiar pathology: chronic appendicitis|journal=BMJ Case Reports|year=2016|pages=bcr2015212485|issn=1757-790X|doi=10.1136/bcr-2015-212485}}</ref> | ||
{{Moderate-begin}}When the referral and/or history suggests chronic appendicitis, take additional slices for microscopy.{{Moderate-end}}<ref group=notes>It will require additional slices to comfortably rule out acute appendicitis.</ref> | |||
==Microscopic evaluation== | ==Microscopic evaluation== | ||
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Chronic appendicitis has predominantly ''mononuclear'' infiltrate rather than neutrophilic.<ref name="SierakowskiPattichis2016"/> It must go beyond the normal histological locations of mononuclear leucocytes of the appendix. | Chronic appendicitis has predominantly ''mononuclear'' infiltrate rather than neutrophilic.<ref name="SierakowskiPattichis2016"/> It must go beyond the normal histological locations of mononuclear leucocytes of the appendix. | ||
Even when chronic appendicitis is detected, also look for acute appendicitis, as well as appendix cancer ({{further|Appendix|linebreak=no}}) | Even when chronic appendicitis is detected, also look for acute appendicitis, as well as appendix cancer.({{further|Appendix|linebreak=no}}) | ||
===Microscopy report=== | ===Microscopy report=== | ||
{{Moderate-begin}}Note even the absence of acute appendicitis.{{Moderate-end}} | |||
Example: | Example: | ||
{|class="wikitable" | {|class="wikitable" | ||
| [[File:Histopathology of patchy chronic peri-appendicitis.jpg|100px|left]] Patchy chronic peri-appendicitis. Negative for | | [[File:Histopathology of patchy chronic peri-appendicitis.jpg|100px|left]] Patchy chronic peri-appendicitis. {{Moderate-begin}}Negative for acute inflammation.{{Moderate-end}} | ||
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