Mucinous cystadenoma of the appendix is a rare condition and represents one of the three entities with the common name mucocele of the appendix. It is characterized by a cystic dilatation of the lumen with stasis of m...Mucinous cystadenoma of the appendix is a rare condition and represents one of the three entities with the common name mucocele of the appendix. It is characterized by a cystic dilatation of the lumen with stasis of mucus inside it. Histopathologically mucocele is divided into three groups： focal or diffuse mucosal hyperplasia, mucinous cystadenoma and mucinous cystadenocarcinoma. This condition is often associated with other neoplasia, especially adenocarcinoma of the colon and ovaries. We here describe a 57 year old male patient who presented with abdominal discomfort, constipation, fresh blood in stool and frequent urination. He had a big cystadenoma of the appendix associated with adenocarcinoma of the colon and hepatocellular carcinoma of the liver. The patient underwent right haemicolectomy, sigmoid colon resection and segmental resection of the liven Now 3 years later he has no evidence of disease relapse. According to this, we stress the need of accurate preoperative diagnosis and intraoperative exploration of the whole abdomen in these patients.展开更多
AIM： The role of the appendix has been highlighted in the pathogenesis of ulcerative colitis （UC）. The aims of this study were to elucidate the immuno-imbalances in the appendix of UC patients, and to clarify the r...AIM： The role of the appendix has been highlighted in the pathogenesis of ulcerative colitis （UC）. The aims of this study were to elucidate the immuno-imbalances in the appendix of UC patients, and to clarify the role of the appendix in the development of UC. METHODS： Colonoscopic biopsy specimens of the appendix, transverse colon, and rectum were obtained from 86 patients with UC： active pancolitis （A-Pan; n = 15）, active letf-sided colitis （A-Lt; n = 25）, A-Lt with appendiceal involvement （A-Lt/Ap; n = 10）, inactive pancolitis （I-Pan; n = 14）, and inactive left-sided colitis （I-Lt; n = 22）, and from controls. In the isolated mucosal T cells, the CD4/CD8 ratio and proportion of activated CD4＋ T ceils were investigated, and compared with controls. RESULTS： in the appendix, the CD4/CD8 ratio significantly increased in A-Lt and A-Lt/Ap. The ratio in the appendix also tended to increase in A-Pan. In the rectum, the ratio significantly increased in all UC groups. In the appendix, the proportion of CD4＋CD69＋ （early activation antigen） T cells significantly increased in all UC groups. In the rectum, the proportion of CD4＋CD69＋ T cells significantly increased only in A-Pan. The proportion of CD4＋HLADR＋ （mature activation antigen） T cells significantly increased only in the rectum of A-Pan, but not in the otherareas of any groups. CONCLUSION： The increased CD4/CD8 ratio and predominant infiltration of CD4＋CD69＋ T cells in the appendix suggest that the appendix is a priming site in the development of UC.展开更多
Objective:To report the prevalence of appendiceal disease in women with chronic pelvic pain undergoing laparoscopy for possible endometriosis,summarize the literature,and more accurately estimate the prevalence of end...Objective:To report the prevalence of appendiceal disease in women with chronic pelvic pain undergoing laparoscopy for possible endometriosis,summarize the literature,and more accurately estimate the prevalence of endometriosis of the appendix. Design:Prospective case series and literature review. Setting:Academic research institute. Patient(s):One hundred thirty-three patients with chronic pelvic pain and possible endometriosis undergoing laparoscopy. Intervention(s):History,physical exam,and abdominopelvic laparoscopy. Endometriosis and adhesions were excised using selective Nd:YAG contact laser trabeculoplasty and pathologically evaluated. Only patients with visible abnormalities involving the appendix were treated via concurrent laparoscopic appendectomy. Main Outcome Measure(s):Appendiceal abnormalities at laparoscopy. Result(s):Of 133 patients,13 had a previous appendectomy with unknown pathology. Of the remaining 120 patients,109 reported right lower quadrant pain. Of this subgroup,six patients had appendiceal pathology:four with pathology-confirmed endometriosis,one with Crohn’s disease suspected at laparoscopy,and one with chronic appendicitis. The prevalence of appendiceal endometriosis in patients with biopsy-proven endometriosis (n = 97) or with right lower quadrant pain (n = 109) was 4.1%and 3.7%,respectively. This rate was similar to the 2.8%prevalence confirmed by literature review in patients with endometriosis but was much higher than that reported in all patients (0.4%). Conclusion(s):Appendiceal endome- triosis,while relatively uncommon in patients with endometriosis,is rare in the general population. In patients with right lower quadrant or pelvic pain,the appendix should be inspected for endometriosis and evidence of nongynecologic disease.展开更多
文摘Mucinous cystadenoma of the appendix is a rare condition and represents one of the three entities with the common name mucocele of the appendix. It is characterized by a cystic dilatation of the lumen with stasis of mucus inside it. Histopathologically mucocele is divided into three groups： focal or diffuse mucosal hyperplasia, mucinous cystadenoma and mucinous cystadenocarcinoma. This condition is often associated with other neoplasia, especially adenocarcinoma of the colon and ovaries. We here describe a 57 year old male patient who presented with abdominal discomfort, constipation, fresh blood in stool and frequent urination. He had a big cystadenoma of the appendix associated with adenocarcinoma of the colon and hepatocellular carcinoma of the liver. The patient underwent right haemicolectomy, sigmoid colon resection and segmental resection of the liven Now 3 years later he has no evidence of disease relapse. According to this, we stress the need of accurate preoperative diagnosis and intraoperative exploration of the whole abdomen in these patients.
基金Supported by the Grant-in-Aid for Scientific Research (C) from the Ministry of Culture and Science of Japan No. 16560645Grant-in-Aid for "Research for the Future" Program from The Japan Society for the Promotion of Science, No. JSPS-RFTF97I00201Supporting in Research Funds from The Japanese Foundation for Research and Promotion of Endoscopy, No. JFE-1997Shimidzu Immunology Foundation, 2000Tenri Foundation for Medical Research, 1997-2000Health and Labour Science Research Grants from the Japanese Ministry of Health, Labour and Welfare, and Research on Measures for Intractable Disease (Inflammatory Bowel Disease)a Grant from the "The 21st Century Center of Excellence (COE)" Program of the Ministry of Education, Culture, Sports, Science and Technology
文摘AIM： The role of the appendix has been highlighted in the pathogenesis of ulcerative colitis （UC）. The aims of this study were to elucidate the immuno-imbalances in the appendix of UC patients, and to clarify the role of the appendix in the development of UC. METHODS： Colonoscopic biopsy specimens of the appendix, transverse colon, and rectum were obtained from 86 patients with UC： active pancolitis （A-Pan; n = 15）, active letf-sided colitis （A-Lt; n = 25）, A-Lt with appendiceal involvement （A-Lt/Ap; n = 10）, inactive pancolitis （I-Pan; n = 14）, and inactive left-sided colitis （I-Lt; n = 22）, and from controls. In the isolated mucosal T cells, the CD4/CD8 ratio and proportion of activated CD4＋ T ceils were investigated, and compared with controls. RESULTS： in the appendix, the CD4/CD8 ratio significantly increased in A-Lt and A-Lt/Ap. The ratio in the appendix also tended to increase in A-Pan. In the rectum, the ratio significantly increased in all UC groups. In the appendix, the proportion of CD4＋CD69＋ （early activation antigen） T cells significantly increased in all UC groups. In the rectum, the proportion of CD4＋CD69＋ T cells significantly increased only in A-Pan. The proportion of CD4＋HLADR＋ （mature activation antigen） T cells significantly increased only in the rectum of A-Pan, but not in the otherareas of any groups. CONCLUSION： The increased CD4/CD8 ratio and predominant infiltration of CD4＋CD69＋ T cells in the appendix suggest that the appendix is a priming site in the development of UC.
文摘Objective:To report the prevalence of appendiceal disease in women with chronic pelvic pain undergoing laparoscopy for possible endometriosis,summarize the literature,and more accurately estimate the prevalence of endometriosis of the appendix. Design:Prospective case series and literature review. Setting:Academic research institute. Patient(s):One hundred thirty-three patients with chronic pelvic pain and possible endometriosis undergoing laparoscopy. Intervention(s):History,physical exam,and abdominopelvic laparoscopy. Endometriosis and adhesions were excised using selective Nd:YAG contact laser trabeculoplasty and pathologically evaluated. Only patients with visible abnormalities involving the appendix were treated via concurrent laparoscopic appendectomy. Main Outcome Measure(s):Appendiceal abnormalities at laparoscopy. Result(s):Of 133 patients,13 had a previous appendectomy with unknown pathology. Of the remaining 120 patients,109 reported right lower quadrant pain. Of this subgroup,six patients had appendiceal pathology:four with pathology-confirmed endometriosis,one with Crohn’s disease suspected at laparoscopy,and one with chronic appendicitis. The prevalence of appendiceal endometriosis in patients with biopsy-proven endometriosis (n = 97) or with right lower quadrant pain (n = 109) was 4.1%and 3.7%,respectively. This rate was similar to the 2.8%prevalence confirmed by literature review in patients with endometriosis but was much higher than that reported in all patients (0.4%). Conclusion(s):Appendiceal endome- triosis,while relatively uncommon in patients with endometriosis,is rare in the general population. In patients with right lower quadrant or pelvic pain,the appendix should be inspected for endometriosis and evidence of nongynecologic disease.
