Appendiceal Crohn's disease clinically presenting as acute appendicitis  

作　　者：Hulin Han Hyunsung Kim Abdul Rehman Se Min Jang Seung Sam Paik 

机构地区：[1]Department of Pathology, College of Medicine, Hanyang University, Seoul 133-792, South Korea

出　　处：《World Journal of Clinical Cases》2014年第12期888-892,共5页世界临床病例杂志

摘　　要：AIM: To determine the incidence of appendiceal Crohn's disease(CD) and to summarize the characteristic histologic features of appendiceal CD.METHODS: We reviewed the pathology files of 2179 appendectomy specimens from January 2007 to May2013. The computer-assisted retrieval search facility was utilized to collect specimens. We selected those cases that were diagnosed as CD or chronic granulomatous inflammation and defined the final diagnosis according to the histologic findings of CD, including transmural lymphocytic inflammation, non-caseating epithelioid granulomas, thickening of the appendiceal wall secondary to hypertrophy of muscularis mucosa,mucosal ulceration with crypt abscesses, mucosal fissures, and fistula formation. RESULTS: We found 12 cases(7 male and 5 female patients, with an average age of 29.8 years) of appendiceal CD. The incidence of appendiceal CD was 0.55%.The chief complaints were right lower quadrant pain,abdominal pain, lower abdominal pain, and diarrhea.The duration of symptom varied from 2 d to 5 mo.The histologic review revealed appendiceal wall thickening in 11 cases(92%), transmural inflammation in all cases(100%), lymphoid aggregates in all cases(100%), epithelioid granulomas in all cases(100%), mucosal ulceration in 11 cases(92%), crypt abscesses in 5 cases(42%), perforation in 2 cases(17%), muscular hypertrophy in 1 case(8%), neural hyperplasia in 5 cases(42%), and perpendicular serosal fibrosis in 8 cases(67%).CONCLUSION: A typical and protracted clinical course, unusual gross features of the appendix and the characteristic histologic features are a clue in the diagnosis of appendiceal CD.AIM: To determine the incidence of appendiceal Crohn's disease(CD) and to summarize the characteristic histologic features of appendiceal CD.METHODS: We reviewed the pathology files of 2179 appendectomy specimens from January 2007 to May2013. The computer-assisted retrieval search facility was utilized to collect specimens. We selected those cases that were diagnosed as CD or chronic granulomatous inflammation and defined the final diagnosis according to the histologic findings of CD, including transmural lymphocytic inflammation, non-caseating epithelioid granulomas, thickening of the appendiceal wall secondary to hypertrophy of muscularis mucosa,mucosal ulceration with crypt abscesses, mucosal fissures, and fistula formation. RESULTS: We found 12 cases(7 male and 5 female patients, with an average age of 29.8 years) of appendiceal CD. The incidence of appendiceal CD was 0.55%.The chief complaints were right lower quadrant pain,abdominal pain, lower abdominal pain, and diarrhea.The duration of symptom varied from 2 d to 5 mo.The histologic review revealed appendiceal wall thickening in 11 cases(92%), transmural inflammation in all cases(100%), lymphoid aggregates in all cases(100%), epithelioid granulomas in all cases(100%), mucosal ulceration in 11 cases(92%), crypt abscesses in 5 cases(42%), perforation in 2 cases(17%), muscular hypertrophy in 1 case(8%), neural hyperplasia in 5 cases(42%), and perpendicular serosal fibrosis in 8 cases(67%).CONCLUSION: A typical and protracted clinical course, unusual gross features of the appendix and the characteristic histologic features are a clue in the diagnosis of appendiceal CD.

关 键 词：APPENDIX APPENDECTOMY ACUTE APPENDICITIS Crohn’s disease Prognosis 

分 类 号：R574.61[医药卫生—消化系统]