A case of xanthogranulomatous appendicitis that was difficult to diagnose

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  • 診断に苦慮した黄色肉芽腫性虫垂炎の1例

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Abstract

<p>A 20-year-old woman with a history of ulcerative colitis since 2006 presented with mild right lower abdominal pain and underwent ultrasonography for routine examination. The root of the appendix was normal with a diameter of 3 mm, but there was a 9-mm-long swollen appendage localized at the blind end. The laminar structure was clear and there was no irregularity of the mucosal surface, no brush echo, and no calcification of the lumen. No blood flow signal was detected. The isolation sign of the surrounding fatty tissue was not prominent, and ascites and enlarged lymph nodes could not be identified. CT/MRI showed similar findings, and appendiceal mucocele was suspected. Appendectomy was performed. Histologically, a xanthogranulomatous reaction consisting of foamy histiocyte aggregation and lymphocytic infiltration was found under the mucosal epithelium of the appendix, so we diagnosed xanthogranulomatous appendicitis. Although the absence of specific findings and the rarity of this condition precluded a preoperative diagnosis, it is necessary to keep in mind that this particular inflammation can occur in the appendix in addition to neoplastic lesions.</p>

Journal

  • Choonpa Igaku

    Choonpa Igaku 50 (2), 121-125, 2023

    The Japan Society of Ultrasonics in Medicine

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