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An Uncommon Case of Chronic Tubercular Appendicitis.

Maharjan S - Case Rep Pathol (2015)

Bottom Line: However, primary TB of the appendix is rare and may or may not be associated with specific clinical features.Thus, diagnosis is made only after histopathological examination.It suggests that all surgically removed appendices should be subjected to histopathological examination.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, Chitwan Medical College Teaching Hospital, P.O. Box 42, Bharatpur-10, Chitwan, Nepal.

ABSTRACT
Tuberculosis (TB) is a common disease that ranks as the second leading cause of death from an infectious disease worldwide, after the human immunodeficiency virus (HIV). However, primary TB of the appendix is rare and may or may not be associated with specific clinical features. Thus, diagnosis is made only after histopathological examination. It suggests that all surgically removed appendices should be subjected to histopathological examination. This reported case is an uncommon case of chronic tubercular appendicitis.

No MeSH data available.


Related in: MedlinePlus

Histopathological examination of appendix showing caseation in the centre with surrounding multinucleated giant cells and epithelioid histiocytes at high power.
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fig4: Histopathological examination of appendix showing caseation in the centre with surrounding multinucleated giant cells and epithelioid histiocytes at high power.

Mentions: Grossly, appendix measured 4.5 × 1 cm. External surface was congested and tubercles were present on the serosal surface and periappendiceal fat (Figure 1). Cut section of appendix showed yellowish foci of caseous necrosis in the wall. Lymph node measured 0.8 × 0.5 cm with focal yellowish area of caseous necrosis likewise in appendix. Histopathological examination revealed transmural inflammation of appendicular wall and also lymph node composed of caseating granulomas with epithelioid histiocytes, Langhans' giant cells, and lymphocytes (Figures 2, 3, and 4). However, tubercle bacilli were not detected by Ziehl-Neelsen (ZN) stain. Diagnosis of tuberculous appendicitis with mesenteric lymph node involvement was given. He was treated with antitubercular therapy in directly observed treatment short course centre (DOTs). The patient was doing well and showed clinical recovery on follow-up in regular intervals. Primary focus was not detected on further investigations of TB involving other organs. HIV was also nonreactive.


An Uncommon Case of Chronic Tubercular Appendicitis.

Maharjan S - Case Rep Pathol (2015)

Histopathological examination of appendix showing caseation in the centre with surrounding multinucleated giant cells and epithelioid histiocytes at high power.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4663290&req=5

fig4: Histopathological examination of appendix showing caseation in the centre with surrounding multinucleated giant cells and epithelioid histiocytes at high power.
Mentions: Grossly, appendix measured 4.5 × 1 cm. External surface was congested and tubercles were present on the serosal surface and periappendiceal fat (Figure 1). Cut section of appendix showed yellowish foci of caseous necrosis in the wall. Lymph node measured 0.8 × 0.5 cm with focal yellowish area of caseous necrosis likewise in appendix. Histopathological examination revealed transmural inflammation of appendicular wall and also lymph node composed of caseating granulomas with epithelioid histiocytes, Langhans' giant cells, and lymphocytes (Figures 2, 3, and 4). However, tubercle bacilli were not detected by Ziehl-Neelsen (ZN) stain. Diagnosis of tuberculous appendicitis with mesenteric lymph node involvement was given. He was treated with antitubercular therapy in directly observed treatment short course centre (DOTs). The patient was doing well and showed clinical recovery on follow-up in regular intervals. Primary focus was not detected on further investigations of TB involving other organs. HIV was also nonreactive.

Bottom Line: However, primary TB of the appendix is rare and may or may not be associated with specific clinical features.Thus, diagnosis is made only after histopathological examination.It suggests that all surgically removed appendices should be subjected to histopathological examination.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, Chitwan Medical College Teaching Hospital, P.O. Box 42, Bharatpur-10, Chitwan, Nepal.

ABSTRACT
Tuberculosis (TB) is a common disease that ranks as the second leading cause of death from an infectious disease worldwide, after the human immunodeficiency virus (HIV). However, primary TB of the appendix is rare and may or may not be associated with specific clinical features. Thus, diagnosis is made only after histopathological examination. It suggests that all surgically removed appendices should be subjected to histopathological examination. This reported case is an uncommon case of chronic tubercular appendicitis.

No MeSH data available.


Related in: MedlinePlus