Original article / research
Year : 2025 Month : October Volume : 14 Issue : 4 Page : PO15 - PO21 Full Version

Histopathological Spectrum of Rare and Diverse Lesions of Vestigial Appendix: A Cross-sectional Study from a Tertiary Care Hospital in Marathwada Region of Maharashtra, India
Shweta Ganorkar, Shazia Anjum, Bharat Sonwane, Deepali Ingale
1. Assistant Professor, Department of Pathology, Government Medical College, Ch. Sambhajinagar, Maharashtra, India. 2. Associate Professor, Department of Pathology, Government Medical College, Ch. Sambhajinagar, Maharashtra, India. 3. Professor and Head, Department of Pathology, Government Medical College, Ch. Sambhajinagar, Maharashtra, India. 4. Junior Resident, Department of Pathology, Government Medical College, Ch. Sambhajinagar, Maharashtra, India.
 
Correspondence Address :
Dr. Shweta Ganorkar,
MIG 236, Shraddha MHADA Colony, Near MSEB Power House, Opposite Dhoot
Hospital, N2 CIDCO, Jalna Road, Ch. Sambhajinagar-431001, Maharashtra, India.
E-mail: academicssdg@gmail.com
 
ABSTRACT
: Introduction: The appendix, though often associated with acute appendicitis, can present with a variety of pathologies, some of which have significant clinical implications. These include rare inflammatory, infectious, and neoplastic conditions that highlight the diagnostic and therapeutic importance of histopathological evaluation.

Aim: To study the spectrum of diverse appendiceal lesions, focusing on their histopathological characteristics and clinical relevance.

Materials and Methods: The present retrospective cross-sectional study analysed 32 appendectomy specimens with rare lesions (January 2022- May 2024) in the Department of Surgical Pathology of a Tertiary Care Hospital in the Marathwada Region of Maharashtra, India. Histopathological evaluation included Haematoxylin and Eosin (H&E) staining, special stains {e.g., Ziehl-Neelsen, Periodic Acid-Schiff (PAS) stain}, Tuberculosis-polymerase Chain Reaction (TB-PCR), and Immunohistochemistry (IHC) for neoplastic cases. Demographics, clinical-radiological data, and histopathological parameters (H&E, special stains, IHC) and TB-PCR wherever needed were analysed. Results were presented as frequencies/percentages using Statistical Package for Social Sciences (SPSS) v24.0 software.

Results: Histopathological analysis identified 13 distinct pathologies among 32 cases: tuberculous appendicitis 5 5 (15.6%), Low-grade Appendiceal Mucinous Neoplasms (LAMN) 8 (25%), appendiceal neuromas 8 (25%), Inflammatory Myofibroblastic Tumour (IMT) 1 (3.1%), and leukaemic infiltration 1 (3.1%). Other significant findings included deposits of mucinous adenocarcinoma 1 (3.1%), Neuroendocrine Tumour (NETs) 1 (3.1%), and appendiceal diverticulum 1 (3.1%). Infectious aetiologies included tapeworm 1 (3.1%) and parasitic infestations 2 (6.25%) and one case of amoebic appendicitis 1 (3.1%). Additionally, mesothelial inclusion cysts 1 (3.1%) and lymphangiectasia 1 (3.1%) were identified. The clinical relevance of each lesion was evaluated by reviewing patient records and operative notes wherever available, and interpreting the potential diagnostic and therapeutic implications of the histological findings.

Conclusion: Histopathological evaluation of appendectomy specimens is crucial for identifying diverse appendiceal lesions, many of which may mimic acute appendicitis clinically. Gross (especially the base of the appendix) and microscopy of every appendix needs to be studied meticulously, irrespective of the clinical diagnosis. Early identification and accurate diagnosis are essential for guiding patient management and improving outcomes. While tuberculous appendicitis and parasitic infections are more common in endemic regions, neoplastic lesions such as LAMN and NETs carry significant implications for prognosis and treatment. Rare entities like appendiceal neuromas and IMT further emphasise the diagnostic value of histopathological examination.
Keywords : Adenocarcinoma, Appendix, Inflammatory myofibroblastic tumour, Tuberculosis
DOI and Others : DOI: 10.7860/NJLM/2025/77383.2945 Date of Submission: Apr 23, 2025 Date of Peer Review: Jun 18, 2025 Date of Acceptance: Aug 07, 2025 Date of Publishing: Oct 01, 2025 AUTHOR DECLARATION • Financial or Other Competing Interests: None • Was Ethics Committee Approval obtained for this study? Yes • Was informed consent obtained from the subjects involved in the study? Yes • For any images presented appropriate consent has been obtained from the subjects. Yes PLAGIARISM CHECKING METHODS: • Plagiarism X-checker: Apr 28, 2025 • Manual Googling: Jul 29, 2025 • iThenticate Software: Aug 06, 2025 (5%) ETYMOLOGY: Author Origin EMENDATIONS: 7
 
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