Difference between revisions of "Chronic appendicitis"
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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> |
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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}}) | + | 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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{{Bottom}} | {{Bottom}} |
Latest revision as of 18:22, 10 September 2020
Author:
Mikael Häggström [note 1]
Chronic appendicitis (including peri-appendicitis):
Contents
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
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:
Patchy chronic peri-appendicitis. (Negative for acute inflammation.) |
Notes
- ↑ It will require additional slices to comfortably rule out acute appendicitis.
- ↑ 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
Image sources