Xanthogranulomatous appendicitis - An incidental finding of localized pathology

The clinical, histopathological, and electron microscopic features of an un usual case of xanthogranulomatous appendicitis are reported. The patient, a 37-year-old female, presented with typical signs of acute appendicitis and the appendix appeared slightly dilated at laparatomy. The histopathologica l sections showed numerous xanthoma cells mixed with inspissated fecaliths. Electron microscopy disclosed the presence of xanthoma cells filled with e lectron-lucent lipid droplets of Variable size. The ultrastructural charact eristics of these cells enabled the distinction of two types of lipid-laden histiocytes, in relationship to the size of the lipid droplets. Since the lipid droplets were seen also in cells other than histiocytes, it appears t hat these changes are secondary to a common mechanism, comprising factors s uch as obstruction, hemorrhage, inflammation, and local hypoxia.