Restricted accessResearch articleFirst published online 2022-5
Acute Appendicitis with Neuronal Hyperplasia and Swelling: A Novel Histologic Mimic of Appendiceal Goblet Cell Adenocarcinoma and Signet-Ring Cell Adenocarcinoma
Goblet cell adenocarcinoma and signet-ring cell adenocarcinoma are well-known diagnostic pitfalls of routine appendectomy specimens. Here we present a case of acute appendicitis with prominent neuronal (ganglion cell) hyperplasia and swelling which histologically mimics goblet cell adenocarcinoma and signet-ring cell adenocarcinoma. Attention to the cytologic features of the lesional cells (absence of atypia, mitotic activity) and their close association with nerves and classic ganglion cells, along with the use of a limited panel of immunostains, ensures proper classification of this rare but striking benign process.
AmberSMathaiAMNaikRPaiMRKumarSPrasadK. Neuronal hypertrophy and mast cells in histologically negative, clinically diagnosed acute appendicitis: a quantitative immunophenotypic analysis. Indian J Gastroenterol. 2010;29(2):69‐73.
3.
YamauchiHSakuraiSTsukagoshiR, et al. A case of diffuse neuronal hypertrophy in acute appendicitis. Int Surg. 2012;97(3):249‐253.
4.
RungtaRLChoiHBTysonJR, et al. The cellular mechanisms of neuronal swelling underlying cytotoxic edema. Cell. 2015;161(3):610‐621.
5.
TangLHShiaJSoslowRA, et al. Pathologic classification and clinical behavior of the spectrum of goblet cell carcinoid tumors of the appendix. Am J Surg Pathol. 2008;32(10):1429‐1443.
6.
NagtegaalIDArendsMJSalto-TellezM. Colorectal adenocarcinoma. In: The WHO Classification of Tumours Editorial Board. WHO Classification of Tumours, volume 1: Digestive System Tumours. 5th ed.International Agency for Research and Cancer (IARC); 2019:177‐187.
7.
MisdrajiJCarrNJPaiRK. Appendiceal adenocarcinoma. In: The WHO Classification of Tumours Editorial Board. WHO Classification of Tumours, volume 1: Digestive System Tumours. 5th ed.International Agency for Research and Cancer (IARC); 2019:147‐148.
8.
MisdrajiJCarrNJPaiRK. Appendiceal goblet cell adenocarcinoma. In: WHO Classification of Tumours Editorial Board. WHO Classification of Tumours, volume 1: Digestive System Tumours. 5th ed.International Agency for Research and Cancer (IARC); 2019:149‐150.
