PMC7512081_01
These sagittal and axial cuts from CT scan after appendectomy shows fluid-filled mildly distended appendicular stump with no abnormally thickened wall. An adjacent well-defined fluid collection is seen caudally, showing a density of 20 Hounsfield units.
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His CT abdomen showed a well-defined mass-like lesion about 5 x 5 cm in diameter of fluid density (22 HU) suggesting thick fluid in the right iliac fossa; the stump of the removed appendix is well demonstrated and about 4 cm in length and closely related to the lower part of this collection (Figure 1).
Operative photograph of laparoscopic exploration showing cecum (green arrow) gelatinous material (blue arrows) and terminal ileum (red arrow).
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The patient underwent laparoscopic exploration with excision of the subserosal appendicular stump of about 5 cm and cyst extending from the tip and distal part of the appendix to the pelvis, easily separable from the pelvis, containing gelatinous yellowish material (Figures 2-4).
Operative picture of the stump (yellow arrow) and mesentery (blue arrow) after the gelatinous material has been separated. The tip was attached to the mucoid jelly-like material and shows abnormal tissue.
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fig3
The patient underwent laparoscopic exploration with excision of the subserosal appendicular stump of about 5 cm and cyst extending from the tip and distal part of the appendix to the pelvis, easily separable from the pelvis, containing gelatinous yellowish material (Figures 2-4).
Laparoscopic view of the stump (green arrow), cecum (orange arrow), and terminal ileum (blue arrow).
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fig4
The patient underwent laparoscopic exploration with excision of the subserosal appendicular stump of about 5 cm and cyst extending from the tip and distal part of the appendix to the pelvis, easily separable from the pelvis, containing gelatinous yellowish material (Figures 2-4).
Low-power view of the lesion, H and E x10. Red arrow highlights the dysplastic mucosa. Note the mucin in the wall (black arrow).
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At the same time, the histopathology of the stump showed appendix measuring 4 cm in length and 0.6 cm in diameter with low-grade appendiceal mucinous neoplasm (LAMN) (Figures 5-7).
High power displaying the atypical mucosa, H and E x20.
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At the same time, the histopathology of the stump showed appendix measuring 4 cm in length and 0.6 cm in diameter with low-grade appendiceal mucinous neoplasm (LAMN) (Figures 5-7).
Dysplastic mucosa lining the lesion, H and E x40.
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fig7
At the same time, the histopathology of the stump showed appendix measuring 4 cm in length and 0.6 cm in diameter with low-grade appendiceal mucinous neoplasm (LAMN) (Figures 5-7).