阑尾增生性息肉1例报告

F. Limaiem, S. Bouraoui, Maroua Bouahmed, G. Sahraoui, A. Lahmar, S. Mzabi-regaya
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引用次数: 2

摘要

在阑尾发现的锯齿状病变在形态上与结直肠类似。阑尾增生性息肉非常罕见,其真实发病率尚不清楚。52岁男性,既往健康,无特殊病史,24小时腹痛,右下腹。体格检查时,右下腹触痛。高度怀疑急性阑尾炎,行腹腔镜阑尾切除术。手术标本的组织学检查显示阑尾壁急性炎症。隐窝局部拉长,但相对直,锯齿主要在隐窝管腔末端可见。柱状细胞有或没有顶端粘液液泡,与大杯状细胞交替。隐窝基部不呈锯齿状,排列有小核的规则细胞。肌层粘膜完整。术后过程顺利,患者于术后第1天出院。最终病理诊断为急性阑尾炎合并增生性息肉。阑尾增生性病变通常是偶然发现的,尽管它们可能与急性阑尾炎有关。它们与大肠其他部位的腺癌显著相关,阑尾切除术中发现的粘膜增生是进一步检查排除结直肠肿瘤的指征。
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Appendiceal Hyperplastic Polyp: Case Report -
Serrated lesions morphologically analogous to those seen in the colorectum are found in the appendix. Appendiceal hyperplastic polyps are very rare, and their true incidence is unknown. A 52-year-old male previously healthy patient with no particular past medical history, presented with a 24-h history of abdominal pain localized to the right lower quadrant. On physical examination, he was tender to palpation in the lower right quadrant. As acute appendicitis was highly suspected, laparoscopic appendectomy was performed. Histological examination of the surgical specimen showed acute inflammation of the appendiceal wall. The crypts were focally elongated but relatively straight with serrations that were visible mainly near the luminal end of the crypts. Columnar cells with or without apical mucous vacuoles alternated with large goblet cells. The crypt bases were not serrated and were lined by regular cells with small nuclei. The muscularis mucosa was intact. The postoperative course was uneventful, and the patient was discharged on postoperative day 1. The final pathological diagnosis was acute appendicitis associated with hyperplastic polyp. Hyperplastic lesions of the appendix are often incidental findings although they can be associated with acute appendicitis. They are significantly associated with adenocarcinoma elsewhere in the large intestine and the finding of mucosal hyperplasia in an appendectomy is an indication for further investigations to exclude colorectal neoplasia.
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