Intravascular lymphocytosis in acute appendicitis: potential mimicry of chronic lymphocytic leukaemia.
OBJECTIVE
Intravascular lymphocytosis (IVL) in appendectomy specimens is a fairly common phenomenon but has not been described and studied in detail. The aim was to describe the IVL phenomenon in appendiceal specimens removed for appendicitis that can mimic chronic lymphocytic leukaemia and to investigate factors that could contribute to the development of IVL.


RESULTS
The clinicopathology of 100 appendectomy cases and the appendices from 20 right hemicolectomy cases were reviewed. The IVL phenomenon was more commonly seen in laparoscopic appendectomy specimens [Fisher's exact 0.011, odds ratio (OR) 3.14] and in patients <38 years old (Fisher's exact 0.012, OR 3.01).


CONCLUSIONS
Surgical manipulation and the patient's innate immunity are contributary factors to the development of the IVL phenomenon. Pathologists should be aware of this histological artefact in order to prevent overdiagnosis of intravascular lymphoid neoplasia.
Lee
Sandra
S
Department of Pathology and Laboratory Medicine, University of Calgary and Calgary Laboratory Services, Calgary, AB, Canada.
Ogilvie
Robert T
RT
Dupre
Marc
M
Gao
Zu-Hua
ZH
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015703:Antigens, CD / Q000378:metabolism; D001062:Appendectomy; D001064:Appendicitis / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D001065:Appendix / Q000473:pathology*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000175:diagnosis*; D008218:Lymphocytosis / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D008297:Male; D008499:Medical Records; D008875:Middle Aged
D015703:Antigens, CD