Role of mast cells and neuronal hypertrophy in acute appendicitis

Acute appendicitis is a common surgical emergency. Appendix continues to be the major chunk of surgical specimens received in Pathology laboratory. However, pathogenesis of appendicitis remains poorly understood. Obstruction and inflammation is implied in pathogenesis of acute appendicitis. Presently there is increasing evidence of involvement of enteric nervous system in immune regulation and in inflammatory responses. The present study combines routine histopathology and immunohistochemistry to study the role of mast cells and enteric nervous system in pathophysiology of acute appendicitis. We have done a prospective study for a period of one and half years from January 2014 to July 2015. Appendicectomy specimens from patients who are clinically diagnosed as acute appendicitis were included in study group as cases. Appendix specimens removed at Forensic autopsies were used as controls. Study was conducted on total 138 appendix specimens of which 118 were surgically removed from patients with acute appendicitis, taken as study group. 20 specimens from Forensic autopsy, were used as comparison group (normal control group). We found a consistent increase in mast cell and neuronal counts along with prominence of ganglion cells in specimens with acute appendicitis compared to the control group.

Hydatid cystic disease at unusual sites

Hydatid disease is a zoonotic infection caused by Echinococcus granulosus, which belongs to phylum Platyhelminthes. It is endemic in many parts of the world including India. Though Hydatid disease commonly occurs in liver and lung no organ or tissue is immune in the body. When it presents in unusual sites Hydatid disease often poses a diagnostic challenge. A high index of suspicion, comprehensive radio imaging investigations are often required to evaluate these cases. In the study we have conducted for 4 years, we reported a total no of 7 Hydatid cases that presented at unusual sites. Most common rare presentation in our study was renal hydatid disease, 3 cases; and one each in pancreas, Spleen, peritoneum and pelvis.