PMC3738361_01
Axial post-contrast CT image showed an enlarged appendix, with severe peri-appendiceal and peri-cecal inflammation and associated fat stranding (white arrows)
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ARSR-12-0017F1
Preoperative contrast-enhanced CT scan (Figs. 1 and 2) showed a wide and severe thickening of the appendiceal walls with extensive soft-tissue stranding and inflammation of the peri-appendicular fat.
Coronal CT multiplanar reconstruction confirms the presence of an enlarged appendix with severe peri-appendiceal and peri-cecal inflammation and fat stranding and associated intra-mural air (white arrows)
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PMC3738361_01_10.1258_arsr.2012.120017-fig2.jpg
ARSR-12-0017F2
Preoperative contrast-enhanced CT scan (Figs. 1 and 2) showed a wide and severe thickening of the appendiceal walls with extensive soft-tissue stranding and inflammation of the peri-appendicular fat.
Low-power view of mucinous and "signet ring cells" adenocarcinoma in the wall of the appendix with lakes of mucin. Normal glands and lymphoid tissue are present (arrow) (HE, x40). Inset: High-power view of the signet ring cells that penetrated the peri-appendiceal fatty tissue. (HE, x400)
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ARSR-12-0017F3
The final histological diagnosis was consistent with well-differentiated infiltrating adenocarcinoma of the appendix with mucinous and "signet ring cells" appearance, with signs of infiltration of peri-appendicular fat and a peritoneal abscess (Fig. 3).  