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Ulusal Travma Ve Acil Cerrahi Dergisi =... Mar 2022Appendix neoplasms are rare tumors of the gastrointestinal system. Appendiceal adenocarcinoma, appendiceal mucinous neoplasm, and neuroendocrine tumors (NETs) are the...
BACKGROUND
Appendix neoplasms are rare tumors of the gastrointestinal system. Appendiceal adenocarcinoma, appendiceal mucinous neoplasm, and neuroendocrine tumors (NETs) are the most encountered appendix-related neoplasms. The patients are usually got diagnosed after histopathological examination. This study aimed to explore the epidemiology, pathological subtypes, and treatment modalities of appendix neoplasms.
METHODS
A retrospective examination was made with 2821 patients who underwent appendectomy between April 2010 and August 2020. Demographic, clinical, radiological, surgical findings, and histopathological results were collected from the patient files.
RESULTS
Appendix neoplasms were detected in 1.06% of the patients included in the study. The mean age was 44.6±17.5 (17-83) years. Eight NETs, seven adenocarcinomas, fourteen mucinous neoplasms, and one neuroma were diagnosed with patients.
CONCLUSION
Appendiceal neoplasms are generally asymptomatic and often diagnosed with postoperative histopathological ex-amination. If the result is adenocarcinoma, right hemicolectomy recommends. Treatment of NETs depends on factors such as tumor size, location, mesoappendix invasion, and lymph node involvement. In the presence of mucinous neoplasm, surgical intervention is determined according to the pathological subtype and involvement of mesoappendix. The need for additional surgical intervention or medical treatment for patients with tumor, histopathological results must be followed carefully after appendectomy.
Topics: Adenocarcinoma; Adult; Appendectomy; Appendiceal Neoplasms; Appendix; Humans; Middle Aged; Neuroendocrine Tumors; Retrospective Studies
PubMed: 35485573
DOI: 10.14744/tjtes.2021.86032 -
PloS One 2022α-Synuclein (α-syn) proteinopathy in the neurons of the Enteric Nervous System (ENS) is proposed to have a critical role in Parkinson's disease (PD) onset and...
α-Synuclein (α-syn) proteinopathy in the neurons of the Enteric Nervous System (ENS) is proposed to have a critical role in Parkinson's disease (PD) onset and progression. Interestingly, the ENS of the human appendix harbors abundant α-syn and appendectomy has been linked to a decreased risk and delayed onset of PD, suggesting that the appendix may influence PD pathology. Common marmosets and rhesus macaques lack a distinct appendix (a narrow closed-end appendage with a distinct change in diameter at the junction with the cecum), yet the cecal microanatomy of these monkeys is similar to the human appendix. Sections of human appendix (n = 3) and ceca from common marmosets (n = 4) and rhesus macaques (n = 3) were evaluated to shed light on the microanatomy and the expression of PD-related proteins. Analysis confirmed that the human appendix and marmoset and rhesus ceca present thick walls comprised of serosa, muscularis externa, submucosa, and mucosa plus abundant lymphoid tissue. Across all three species, the myenteric plexus of the ENS was located within the muscularis externa with nerve fibers innervating all layers of the appendix/ceca. Expression of α-syn and tau in the appendix/cecum was present within myenteric ganglia and along nerve fibers of the muscularis externa and mucosa in all species. In the myenteric ganglia α-syn, p-α-syn, tau and p-tau immunoreactivities (ir) were not significantly different across species. The percent area above threshold of α-syn-ir and tau-ir in the nerve fibers of the muscularis externa and mucosa were greater in the human appendix than in the NHP ceca (α-syn-ir p<0.05; tau-ir p<0.05). Overall, this study provides critical translational evidence that the common marmoset and rhesus macaque ceca are remarkably similar to the human appendix and, thus, that these NHP species are suitable for studying the development of PD linked to α-syn and tau pathological changes in the ENS.
Topics: Animals; Appendix; Enteric Nervous System; Humans; Macaca mulatta; Parkinson Disease; alpha-Synuclein; tau Proteins
PubMed: 35687573
DOI: 10.1371/journal.pone.0269190 -
Nature Communications Jan 2024The microbiome in a specific human organ has been well-studied, but few reports have investigated the multi-organ microbiome as a whole. Here, we aim to analyse the...
The microbiome in a specific human organ has been well-studied, but few reports have investigated the multi-organ microbiome as a whole. Here, we aim to analyse the intra-individual inter-organ and intra-organ microbiome in deceased humans. We collected 1608 samples from 53 sites of 7 surface organs (oral cavity, esophagus, stomach, small intestine, appendix, large intestine and skin; n = 33 subjects) and performed microbiome profiling, including 16S full-length sequencing. Microbial diversity varied dramatically among organs, and core microbial species co-existed in different intra-individual organs. We deciphered microbial changes across distinct intra-organ sites, and identified signature microbes, their functional traits, and interactions specific to each site. We revealed significant microbial heterogeneity between paired mucosa-lumen samples of stomach, small intestine, and large intestine. Finally, we established the landscape of inter-organ relationships of microbes along the digestive tract. Therefore, we generate a catalogue of bacterial composition, diversity, interaction, functional traits, and bacterial translocation in human at inter-organ and intra-organ levels.
Topics: Humans; Bacterial Translocation; Stomach; Appendix; Microbiota; Mouth
PubMed: 38199995
DOI: 10.1038/s41467-024-44720-6 -
Turkish Journal of Surgery Mar 2022The length and the attachment of the mesoappendix is important in the degree of inflammation, spread of tumor and during surgical resection of the appendix. The presence...
OBJECTIVES
The length and the attachment of the mesoappendix is important in the degree of inflammation, spread of tumor and during surgical resection of the appendix. The presence of accessory appendicular artery along with varied origin of appendicular artery may cause intra- as well as post-operative complications. Hence, the study of length of mesoappendix and the origin and branching pattern of arterial supply to the appendix was undertaken.
MATERIAL AND METHODS
Sixty formalin fixed appendix specimens were resected along with the intact mesopappendix and were dissected to analyze the extent of attachment, origin of appendicular arteries and the accessory branches as well.
RESULTS
The whole length mesoappendix was seen in 76% and the half length mesoappendix was not found. The main appendicular artery originated from the ileocolic artery in 80%, and accessory appendicular artery was seen in 13% of the study specimens.
CONCLUSION
The mesoappendix and the branching pattern of the appendicular artery varies from person to person, and this awareness will be of use during surgeries on appendix.
PubMed: 35873747
DOI: 10.47717/turkjsurg.2022.5502 -
Revista Brasileira de Ginecologia E... 2024To evaluate the association between clinical and imaging with surgical and pathological findings in patients with suspected neuroendocrine tumor of appendix and/or...
OBJECTIVE
To evaluate the association between clinical and imaging with surgical and pathological findings in patients with suspected neuroendocrine tumor of appendix and/or appendix endometriosis.
METHODS
Retrospective descriptive study conducted at the Teaching and Research Institute of , in which medical records and databases of patients with suspected neuroendocrine tumor of appendix and/or endometriosis of appendix were analyzed by imaging.
RESULTS
Twenty-eight patients were included, all of which had some type of appendix alteration on the ultrasound examination. The pathological outcome of the appendix found 25 (89.3%) lesions compatible with endometriosis and three (10.7%) neuroendocrine tumors. The clinical findings of imaging and surgery were compared with the result of pathological anatomy by means of relative frequency.
CONCLUSION
It was possible to observe a higher prevalence of appendix endometriosis when the patient presented more intense pain symptoms. The image observed on ultrasound obtained a high positive predictive value for appendicular endometriosis.
Topics: Humans; Female; Endometriosis; Retrospective Studies; Adult; Ultrasonography; Neuroendocrine Tumors; Appendix; Middle Aged; Diagnosis, Differential; Young Adult; Appendiceal Neoplasms; Cecal Diseases
PubMed: 38765516
DOI: 10.61622/rbgo/2024AO01 -
Cureus Oct 2022Cecal appendix tumors are unusual and have a low frequency of presentation, which is reported between 0.2 and 0.5% of all digestive tract tumors. From the mentioned...
Cecal appendix tumors are unusual and have a low frequency of presentation, which is reported between 0.2 and 0.5% of all digestive tract tumors. From the mentioned tumors, the carcinoid ones are the most common neoplasms of the cecal appendix and are characterized in most cases by slow growth and an asymptomatic clinical course. However, in some cases, they can present as a metastatic disease with fatal outcomes. We report the case of a 24-year-old female patient with a typical case of acute appendicitis, in whom an additional diagnosis of a carcinoid tumor is obtained upon receipt of the pathology report. The prognosis of appendicular carcinoid tumors is good, with a five-year survival rate of 95%-100% and a recurrence rate of less than 1%.
PubMed: 36447686
DOI: 10.7759/cureus.30793 -
Turk Patoloji Dergisi 2023Parasites and plant seeds may both be found in appendectomy specimens. Each plant seed has a different appearance and can thus exhibit wide variations under the... (Review)
Review
OBJECTIVE
Parasites and plant seeds may both be found in appendectomy specimens. Each plant seed has a different appearance and can thus exhibit wide variations under the microscope. Fragmented seeds may histologically mimic parasites. The differential diagnosis between seeds and parasites can be challenging in such cases. This study aimed to determine the incidence of parasites, seeds, and foreign bodies in appendectomy materials and highlight the most characteristic histopathological features associated with these structures.
MATERIAL AND METHOD
In this study, pathology slides of 9,480 patients, who underwent appendectomy between 2010 and 2021, were reviewed, and cases that contained parasites, seeds, or foreign bodies were identified. We reviewed the literature on seeds and parasites in appendectomy specimens.
RESULTS
Parasites were observed in 56 (0.6%) cases. Of these cases, 45 had Enterobius vermicularis (80%), and 11 had Taenia subspecies (20%). Plant seeds were observed in 47 cases (0.5%), and were macroscopically recognizable in 5 of them as olive, lemon, and cherry seeds. Parasites and seeds were usually observed in the lumen of appendix vermiformis, filled with abundant fecal materials.
CONCLUSION
Seeds are seen in approximately 0.5% of the appendectomy specimens. Though rarely seen, the fragmented seed appearance may cause diagnostic difficulties. In this context, the key morphological features of parasites and plant seeds outlined in this study may be helpful in their differential diagnosis.
Topics: Animals; Humans; Appendix; Parasites; Appendicitis; Enterobiasis; Retrospective Studies; Appendectomy; Foreign Bodies
PubMed: 36647674
DOI: 10.5146/tjpath.2022.01586 -
BMJ Case Reports Feb 2021A 21-year-old female patient presented with vague lower abdominal pain associated with nausea since 2 days. On examination, she was tender in the right iliac fossa.... (Review)
Review
A 21-year-old female patient presented with vague lower abdominal pain associated with nausea since 2 days. On examination, she was tender in the right iliac fossa. Based on clinical presentation and radiological test finding, she was diagnosed as appendicitis and was subjected for diagnostic laparoscopy and appendectomy. Histopathology proved it to be a tubercular appendix, which is a rarely encountered entity. However, in a country like India, tuberculosis (TB) is highly prevalent; however, TB of appendix is rare and less known.
Topics: Abdominal Pain; Adult; Appendicitis; Appendix; Female; Humans; India; Laparoscopy
PubMed: 33542013
DOI: 10.1136/bcr-2020-237718 -
The Pan African Medical Journal 2022
Topics: Humans; Mucocele; Appendix; Appendectomy; Intestinal Diseases; Cecal Diseases; Appendiceal Neoplasms
PubMed: 36762160
DOI: 10.11604/pamj.2022.43.123.33175 -
International Journal of Surgery Case... Oct 2022Acute appendicitis is a clinical diagnosis with marked variations in the clinical presentation, the latter resultant of varied anatomical positions of the appendix.
INTRODUCTION AND IMPORTANCE
Acute appendicitis is a clinical diagnosis with marked variations in the clinical presentation, the latter resultant of varied anatomical positions of the appendix.
PRESENTATION OF CASE
Here we present the first documented case of the vermiform appendix located in the ascending colon of a young South Asian male who presented with right upper abdominal pain. The ultrasound scan of the abdomen failed to visualise the appendix in the right iliac fossa. Persistent symptoms despite conservative therapy and elevated inflammatory markers warranted an open laparotomy. The histology further confirmed acute appendicitis.
CLINICAL DISCUSSION
Atypical locations and congenital anomalies of the appendix are relatively rare entities. Appendicular duplication and hypoplasia are the predominant varieties of congenital anomalies. Caecal diverticula might mimic acute appendicitis despite the relative rarity and absence of all three layers of intestinal wall, which could be of use in distinguishing an abnormally located appendix.
CONCLUSION
Such deviations from the norm lead to atypical clinical and imaging findings where operative interventions might be required in place of non-operative care, especially in instances of persistent symptomatology.
PubMed: 36261940
DOI: 10.1016/j.ijscr.2022.107726