Difference between revisions of "Chronic appendicitis"

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Chronic [[appendicitis]]:
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Chronic [[appendicitis]] (including peri-appendicitis):
  
 
{{Fixation - standard}}
 
{{Fixation - standard}}
 
{{Fixation - general notes}}
 
{{Fixation - general notes}}
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{{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>
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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>
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{{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}})
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Even when chronic appendicitis is detected, also look for acute appendicitis, as well as appendix cancer.({{further|Appendix|linebreak=no}})
  
 
===Microscopy report===
 
===Microscopy report===
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{{Moderate-begin}}Note even the absence of acute appendicitis.{{Moderate-end}}
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Example:
 
Example:
 
{|class="wikitable"
 
{|class="wikitable"
| [[File:Histopathology of patchy chronic peri-appendicitis.jpg|100px|left]] Patchy chronic peri-appendicitis. Negative for suppurative inflammation.
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| [[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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Latest revision as of 18:22, 10 September 2020

Author: Mikael Häggström [note 1]
Chronic appendicitis (including peri-appendicitis):

Fixation

Generally 10% neutral buffered formalin.

  See also: General notes on fixation


Comprehensiveness

On this resource, the following formatting is used for comprehensiveness:

  • Minimal depth
  • (Moderate depth)
  • ((Comprehensive))

Gross processing

Further information: Appendix A major visual clue to chronic appendicitis is fibrosis.[1]

(When the referral and/or history suggests chronic appendicitis, take additional slices for microscopy.)[notes 1]

Microscopic evaluation

Patchy chronic peri-appendicitis.

Further information: Appendicitis Chronic appendicitis has predominantly mononuclear infiltrate rather than neutrophilic.[1] 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 information: Appendix )

Microscopy report

(Note even the absence of acute appendicitis.)

Example:

Histopathology of patchy chronic peri-appendicitis.jpg
Patchy chronic peri-appendicitis. (Negative for acute inflammation.)

Notes

  1. It will require additional slices to comfortably rule out acute appendicitis.
  1. 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. 1.0 1.1 Sierakowski, Kyra; Pattichis, Andrew; Russell, Patrick; Wattchow, David (2016). "Unusual presentation of a familiar pathology: chronic appendicitis ". BMJ Case Reports: bcr2015212485. doi:10.1136/bcr-2015-212485. ISSN 1757-790X. 

Image sources