Serrated lesions morphologically analogous to those seen in the colorectum are found in the appendix. Appendiceal hyperplastic polyps are very rare, and their true incidence is unknown. A 52-year-old male previously healthy patient with no particular past medical history, presented with a 24-h history of abdominal pain localized to the right lower quadrant. On physical examination, he was tender to palpation in the lower right quadrant. As acute appendicitis was highly suspected, laparoscopic appendectomy was performed. Histological examination of the surgical specimen showed acute inflammation of the appendiceal wall. The crypts were focally elongated but relatively straight with serrations that were visible mainly near the luminal end of the crypts. Columnar cells with or without apical mucous vacuoles alternated with large goblet cells. The crypt bases were not serrated and were lined by regular cells with small nuclei. The muscularis mucosa was intact. The postoperative course was uneventful, and the patient was discharged on postoperative day 1. The final pathological diagnosis was acute appendicitis associated with hyperplastic polyp. Hyperplastic lesions of the appendix are often incidental findings although they can be associated with acute appendicitis. They are significantly associated with adenocarcinoma elsewhere in the large intestine and the finding of mucosal hyperplasia in an appendectomy is an indication for further investigations to exclude colorectal neoplasia.
Appendix, appendicitis, hyperplastic polyp, histopathology