The case of coexistent low-grade mucinous neoplasm, diverticulum, and pseudo-myxoma peritonei suggests that diverticula could play a role in the pathogenesis of pseudomyxoma peritonei. Of the appendices with both low-grade mucinous neoplasms and diverticula, three contained dissecting acellular mucin within the appendiceal wall, four showed diverticular perforation, and one had pseudomyxoma peritonei associated with the ruptured diverticulum.Ī significant percentage ( P <.001) of cases contained low-grade mucinous neoplasms and diverticula together. Thus, 8 of 19 low-grade mucinous neoplasms (42%) were associated with diverticula. Twenty-five percent of the total cases (8 of 32) contained both a low-grade mucinous neoplasm (7 cystadenomas and 1 mucinous tumor of unknown malignant potential) and a diverticulum. Binomial statistics were used to calculate the probability that the observed prevalence of low-grade mucinous neoplasms and diverticula together was significantly different from the expected prevalence of diverticula or low-grade mucinous neoplasms alone, using historical controls from the literature. Medical records were reviewed for multiple parameters, including presenting symptoms, presence of pseudomyxoma peritonei, and presence of associated malignancies. Cases were classified as adenomas or mucinous tumors of unknown malignant potential, with or without diverticula. Invasive adenocarcinomas and retention cysts were excluded (six cases). Other, describe and measure according to the relevant tissue protocol.We examined 38 appendectomies with diagnoses of mucocele, diverticulum, or adenoma to study the coincidence of appendiceal diverticula and appendiceal low-grade mucinous neoplasms and to examine the possible role of diverticula in the pathogenesis of pseudomyxoma peritonei.Right hemicolectomy and appendicectomy see colorectal tumour protocolĪnatomical components included (more than one may apply) and dimensions (mm)ĭescribe and measure the anatomical components present.Orientate and identify anatomical features of the specimen including appendix tip and proximal margin.ĭescribe the following features of the specimen: Procedure Record as stated by the clinician. Inspect the specimen and dictate a macroscopic description. See general information for more detail on specimen handling procedures. See overview page for more detail on identification principles. Record the patient identifying information and any clinical information supplied together with the specimen description as designated on the container. A review of the serosal surface for any abnormalities would also be recommended. It is suggested that the appendicular and mesoappendicular resection margins as well as lymph nodes should be submitted for processing. In these cases, more extensive sampling of the appendix is required 8. While tumours of the appendix are uncommon, neuroendocrine (carcinoid) tumours and adenocarcinomas do occur 6,7 and can be incidental findings in cases of appendicitis (found in 0.1 to 0.6 per cent of appendectomies) 1. 1 It is recommended that all tissue is examined carefully before stating that no inflammation is present. Oedema, purulent serosal exudate or perforation may be present but appendicitis is not always evident macroscopically. Clinical symptoms vary 2 and normal appendiceal diameters overlap cases of inflamed appendix on imaging. False positive and false negative diagnoses of appendicitis occur preoperatively.
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