Eosinophils in acute appendicitis: possible significance.
ABSTRACT 120 consecutive appendicectomies and 20 appendices from medicolegal autopsies were studied. The cases were grouped as. A: Acute appendicitis. B: Acute presentation, not diagnostic of acute appendicitis C: Elective appendicectomies D: Normal appendices from autopsies. Eosinophils and mast cells were counted in the muscularis, in Giemsa stained sections. The mean eosinophil and mast cell counts per mm2 were--A. 215.9; 26.5. B. 66.0; 32.1. C. 6.7; 25.8. D. 4.2; 19.6 respectively. Eosinophil count is significantly higher in A compared to others (p < 0.0001) and there was no range overlap with C and D. B is a heterogenous group with 37.5% having eosinophil counts in the range seen in A. Cases with mural eosinophil showed histological evidence of mast cell degranulation. Eosinophil infiltration of the muscularis is an early event universally seen in acute appendicitis. It is possible that the disease is triggered by Type I Hypersensitivity, and that infection is a later consequence.
Full-textDOI: · Available from: Aravindan Kp, Jun 08, 2015
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ABSTRACT: The purpose of this study was to find the unusual findings in the childhood appendectomy specimens and their incidence. The clinicopathological data of 1,306 patients whose ages ranged from 3 to 16 were retrospectively collected. Histopathological findings in appendectomy specimens taken from patients who had a prediagnosis of appendicitis were obtained. Incidental appendectomies were not included in the research. Unusual findings were reevaluated in the histopathological assessment of appendectomy specimens. The number of patients whose pathological findings are considered unusual is 25 (1.91 %). Nine of the patients were girls and 16 of them were boys. Their ages ranged from 6 to 15. Pathological results revealed that there were 16 (1.22 %) cases of parasitosis, 3 (0.23 %) cases of granulomatosis, 3 (0.23 %) cases of eosinophilic appendicitis, 2 (0.15 %) cases of carcinoid tumors, and 1 (0.08 %) case of appendiceal non-Hodgkin’s lymphoma. All patients underwent a standard appendectomy. Uncommon histopathological findings in childhood appendectomy specimens are more common than those in adulthood. This kind of certain unexpected lesions of the appendix may require advanced diagnostics, careful clinical care, follow-up for years, and a multidisciplinary approach. Therefore, histopathological examinations of appendectomy specimens must be performed routinely.Indian Journal of Surgery 01/2013; DOI:10.1007/s12262-013-0934-0 · 0.27 Impact Factor
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ABSTRACT: Twenty to thirty percent appendices removed from patients with suspected appendicitis appear normal on histology. The cause of pain in these patients is unknown. The presence of eosinophils and mast cells should be looked at skeptically which may explain the cause of pain. The aim was to study the eosinophils, mast cells, nerves and ganglions in normal and inflamed appendices. A total of 329 appendices including 192 case of acute appendicitis (group A), 94 cases of clinically acute but histologically normal appendices (group B), 13 cases of complementary/elective appendicectomies (group C) and 30 normal controls from medico-legal autopsies(group D), were studied for the presence of eosinophils, mast cells, nerves and ganglia in mucosa, submucosa and muscularis propria. Routine haematoxylin and eosin stained sections were used for eosinophils, nerves and ganglia and Toludine blue sections for mast cell counts. One way ANOVA and logistic regression was used for statistical analysis The mean eosinophil and mast cell counts were significantly higher in mucosa, submucosa and muscularis propria in Group A and B, when compared to group C+D. The number of nerves and ganglion cells were significantly higher in group A when compared to groups B and C+D. The correlation between eosinophil and mast cell count was not found to be statistically significant. A significant increase in Eosinophils, mast cells, nerves and ganglion cells was seen in acute appendicitis. Increase in eosinophils and mast cells may explain the pain in histologicaly normal but clinically suspected acute appendicitis.Indian Journal of Surgery 10/2008; 70(5):231-4. DOI:10.1007/s12262-008-0066-0 · 0.27 Impact Factor