Significance of acquired diverticular disease of the vermiform appendix: a marker of regional neoplasms?
- 1Department of Pathology, Copenhagen University Hospital, Hvidovre, Denmark
- 2Department of Gastroenterology, Copenhagen University Hospital, Hvidovre, Denmark
- Correspondence to Professor Susanne Holck, Department of Pathology, Hvidovre Hospital, University of Copenhagen, Kettegård Alle 30, Hvidovre, DK-2650, Denmark;
Contributors KK: Collection of retrospective and prospective material, evaluation of data. SVH: Collection of retrospective material. UE: Collection of prospective material. NHS: Evaluation of data. SH: Evaluation of data, review of material, formulation of the manuscript.
- Accepted 20 February 2012
- Published Online First 29 March 2012
Aim To assess the prevalence of acquired diverticulum of the appendix (DA), including incipient forms and its possible significance as a marker of local/regional neoplasms.
Materials and Methods The pathology database at Hvidovre Hospital was searched for appendix specimens, received between 2001 and 2010, coded for DA or for a space-occupying lesion. Slides were reviewed to determine DA status and the nature of lesions possibly causing DA.
Result Among 4413 appendix specimens, DA were identified in 39 (0.9%, CI 0.6% to 1.2%) cases, 17 (43.6%, 28.0% to 59.2%) of which additionally harboured an appendiceal neoplasm/neoplastic precursor, whereas this figure was 1.2% (CI 0.9% to 1.6%) for non-DA specimens (p<0.0001). Six of the 39 DA specimens comprised incipient DA, three of which coexisted with appendiceal neoplasms. In addition, local/regional non-neoplastic lesions (six cases) and colorectal carcinomas (four cases) coexisted with DA.
Conclusion DA has significance as a putative marker of local/regional neoplasms. Therefore, a DA specimen proved significantly more likely to harbour a neoplastic growth than a non-DA counterpart. Submission for microscopy of the entire DA specimen, whether transmural or only incipient, and a comment in the pathology report on the occasional concurrence of local/regional neoplasms in this setting seem appropriate. The observation of DA may thus provide a valuable contribution in the diagnostic process.
- Appendiceal diverticulosis-associated diseases
- colorectal cancer
Part of this study has previously been presented at the annual meeting of DSPAC, 2011 (APMIS 2011;119(Suppl 131):15).
Competing interests None.
Ethics approval Ethics approval was provided by the Scientific Ethical Committee of Region Hovedstaden.
Provenance and peer review Not commissioned; externally peer reviewed.