AJSP2403 - CME/CMLE - CME/CMLE - Nonneoplastic pathology of the appendix-Nonneoplastic pathology of the appendix

Nonneoplastic pathology of the appendix

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The article discusses the wide range of nonneoplastic pathologies that can affect the appendix, emphasizing the clinical and prognostic significance often underestimated by pathologists. The appendix, considered a vestigial organ, is revealed to play an important role in certain medical conditions. The document offers insights into the diverse pathologies encountered in the appendix, ranging from infections and inflammations to rare entities such as granulomatous appendicitis, endometriosis, and appendiceal diverticular disease. It highlights the importance of meticulous histologic evaluation to distinguish these pathologies, providing practical guidance on gross examination and microscopy techniques to identify subtle yet clinically significant findings.<br /><br />Granulomatous appendicitis, known to have various etiologies depending on geographic locations, is explored in detail, emphasizing the importance of considering causes like tuberculosis, Yersinia infection, and Actinomyces. The article also touches upon unique cases such as taxane-induced epithelial changes, IgG4-related appendiceal disease, and gastrointestinal malakoplakia, underscoring the need for accurate diagnosis and appropriate management.<br /><br />Furthermore, the article sheds light on clinical audit implications, such as negative appendectomy rates, serving as a quality measure for surgical interventions. It also addresses the concept of chronic appendicitis, emphasizing careful diagnosis to avoid misinterpretation. Additionally, the article delves into unexpected pathologies and areas prone to misdiagnosis, highlighting the importance of recognizing rare conditions like Rosai-Dorfman-Destombes disease, and seed identification in forensic botany to determine the time of death accurately.<br /><br />Lastly, the article discusses evolving perspectives on the appendix's physiological role, challenging the notion of it being a vestigial organ. The article concludes by pointing out the diverse lessons and complex pathologies the appendix presents, encompassing physiological, embryological, and pathological aspects that contribute to a broader understanding of this often underestimated organ.

Keywords

nonneoplastic pathologies

appendix

clinical significance

prognostic significance

granulomatous appendicitis

endometriosis

appendiceal diverticular disease

histologic evaluation

tuberculosis

Yersinia infection