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What Does The Following Pathology Report Indicate?

Posted on Tue, 6 Oct 2015

Question: A few weeks ago I have my appendix removed. This is the anatomic pathology report. Please can you tell me which disease I had?

Anatomical pathology of appendix
-------------------------------------------------
Appendix with intense follicular lymphoid hyperplasia of reactive Germinal centers.
We don't observe polynuclear neutrophil infiltration
Distal segment side mucosa partially obliterated by fibroadipose tissue, with luminal obliteration
In the periappendicular adipose tissue we see a Lymphatic ganglion with follicular hyperplasia

Answered by Dr. Dr.P.Ratnakar Kini (2 hours later)

Brief Answer:
Features of appendicitis due to lymphoid hyperplasia

Detailed Answer:
Hi,
Thanks for posting your query.
I am Dr.R.K and I am pleased to assist you.

If you had right lower abdominal pain for which appendix was removed, then probably the pain was due to obstruction in the appendix. This has happened to to multiplication of the cells of the regional lymphatic tissues ( which are related to immunity). This is what is mentioned in the report.

I hope that answers your query.
Let me know if you have any more question.
Regards,
Dr.R.K.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr.P.Ratnakar Kini (1 hour later)

Sorry I didn't mention my symptoms.

Yes, I have had right abdominal pain and pain around my belly button during a whole year and a half :( and some days diarrhea.

Finally the surgeon performs an exploratory laparotomy found a slightly thickened appendix, and he removes it, and that is the anatomic pathology report I have posted.

My question is: Is it possible to have appendicitis during a year and a half?. I am very puzzled, because acute appendicitis usually last a day or two (before ER surgery).

Answered by Dr. Dr.P.Ratnakar Kini (11 hours later)

Brief Answer:
Answer given below

Detailed Answer:
Hi,
Thanks for the additional information.

The report says there is no polynuclear neutrophil infiltration which means at the time of removal of appendix there was NO ACUTE APPENDICITIS.

But the appendix would have got inflamed sometime ago due to the immune cells multiplication causing obstruction of the lumen of appendix.

Yes as name suggests Acute appendicitis is an acute issue only.
What you had is probably chronic appendicitis.

I hope that answers your question.
Let me know if you have any more questions.
Regards,
Dr.R.K.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr.P.Ratnakar Kini (13 minutes later)

Thank you very much for your answer.

I only have a last question:

is it possible that the reason of my constant pain everyday was obstruction of the lumen of appendix due to chronic appendicitis?.

Thank you in advance.

Answered by Dr. Dr.P.Ratnakar Kini (10 minutes later)

Brief Answer:
Yes

Detailed Answer:
Hi,
Your abdominal pain could be due to obstruction of the lumen of the appendix and chronic appendicitis.

Regards,
Dr.R.K.

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar