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Significance of acquired diverticular disease of the vermiform appendix: a marker of regional neoplasms?
  1. Klaus Kallenbach1,
  2. Sofie Vetli Hjorth1,
  3. Ulla Engel1,
  4. Nis Hallundbæk Schlesinger2,
  5. Susanne Holck1
  1. 1Department of Pathology, Copenhagen University Hospital, Hvidovre, Denmark
  2. 2Department of Gastroenterology, Copenhagen University Hospital, Hvidovre, Denmark
  1. Correspondence to Professor Susanne Holck, Department of Pathology, Hvidovre Hospital, University of Copenhagen, Kettegård Alle 30, Hvidovre, DK-2650, Denmark; susanne.holck{at}


Aim To assess the prevalence of acquired diverticulum of the appendix (DA), including incipient forms and its possible significance as a marker of local/regional neoplasms.

Materials and Methods The pathology database at Hvidovre Hospital was searched for appendix specimens, received between 2001 and 2010, coded for DA or for a space-occupying lesion. Slides were reviewed to determine DA status and the nature of lesions possibly causing DA.

Result Among 4413 appendix specimens, DA were identified in 39 (0.9%, CI 0.6% to 1.2%) cases, 17 (43.6%, 28.0% to 59.2%) of which additionally harboured an appendiceal neoplasm/neoplastic precursor, whereas this figure was 1.2% (CI 0.9% to 1.6%) for non-DA specimens (p<0.0001). Six of the 39 DA specimens comprised incipient DA, three of which coexisted with appendiceal neoplasms. In addition, local/regional non-neoplastic lesions (six cases) and colorectal carcinomas (four cases) coexisted with DA.

Conclusion DA has significance as a putative marker of local/regional neoplasms. Therefore, a DA specimen proved significantly more likely to harbour a neoplastic growth than a non-DA counterpart. Submission for microscopy of the entire DA specimen, whether transmural or only incipient, and a comment in the pathology report on the occasional concurrence of local/regional neoplasms in this setting seem appropriate. The observation of DA may thus provide a valuable contribution in the diagnostic process.

  • Appendiceal diverticulosis-associated diseases
  • appendix
  • carcinoma
  • colorectal cancer
  • gastroenterology
  • histopathology
  • inflammation

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  • Part of this study has previously been presented at the annual meeting of DSPAC, 2011 (APMIS 2011;119(Suppl 131):15).

  • Competing interests None.

  • Ethics approval Ethics approval was provided by the Scientific Ethical Committee of Region Hovedstaden.

  • Provenance and peer review Not commissioned; externally peer reviewed.