Histopathologic study of Mucinous lesions of the appendix

Authors : Ch Geetha, Asra Farheen, A K Deshpande

DOI : 10.18231/j.achr.2020.010

Volume : 5

Issue : 1

Year : 2020

Page No : 41-46

Introduction: Mucinous lesions of appendix are rare with an incidence of about 0.2 to 0.7% of all
the appendicetomy specimens. The mucinous lesions of appendix range from simple retention cyst to
malignant mucinous adenocarcinoma. Majority of mucinous appendiceal neoplasia are epithelial type
(70%) with circumferential involvement of mucosa. Peritoneal seeding and pseudomyxoma peritonei can
occur with both frankly malignant as well as low-grade appendiceal neoplasms. Nearly 50% of appendiceal
malignancies present clinically as acute appendicitis and can be detected by imaging modalities. Aim of
this study is to analyse the incidence, age and sex prediliction, clinical presentation and histopathology of
mucinous lesions of appendix.
Materials and Methods: It is a reterospective study of all the mucinous lesions of appendix diagnosed at
Dept. of Pathology, Kamineni Academy of Medical Sciences and Reserch Centre (KAMSRC) from 2013-
2017. Clinical details and relevant radiological investigations are noted from case sheets. Microscopic
examination is done on slides stained with routine H & E and AB-PAS. Diagnosis and classification is
based on WHO 2010 and recommendations in the AJCC 8th edition.
Results: Mucinous lesions accounted for 0.8% (10/1200). of all appendicetomy specimens. The study
included 10 cases of mucinous lesions of appendix(10 cases): Simple mucocele (2 cases), Benign mucinous
adenomas(3 cases), Low grade Appendiceal Mucinous Neoplasm (LAMN) with pseudomyxoma peritoni
(PMP) (1 case), Mucinous cystadeno carcinomas (4 cases). Benign lesions are seen in females and at a
younger age as compared to malignancies which are common in males and at a older age. Most common
presentation is abdominal pain followed by appendicitis. Mucosal hyperplasia and high grade appendiceal
mucinous neoplasms(HAMN) are not seen in our study.
Conclusion: Mucinous lesions of appendix are rare. They are more common in females and associated with
non-specific clinical features. Histopathology is critical for establishing diagnosis, further management and
prognostication of all the mucinous lesions of appendix.

Keywords: Appendiceal mucinous tumors, Cystadenoma, Cystadenocarcinoma, Mucocele, Histopathology.


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