title: Significance of acquired diverticular disease of the vermiform appendix: a marker of regional neoplasms?
abstract: OBJECTIVE
  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.
  
  
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Pathology, Copenhagen University Hospital, Hvidovre, Denmark.
authors.forename: Klaus
authors.initials: K
authors.lastname: Kallenbach
authors.forename: Sofie Vetli
authors.initials: SV
authors.lastname: Hjorth
authors.forename: Ulla
authors.initials: U
authors.lastname: Engel
authors.forename: Nis Hallundbæk
authors.initials: NH
authors.lastname: Schlesinger
authors.forename: Susanne
authors.initials: S
authors.lastname: Holck
mesh_terms: D001063:Appendiceal Neoplasms / Q000453:epidemiology*; D001065:Appendix / Q000473:pathology*; D014408:Biomarkers, Tumor; D002429:Cecal Diseases / Q000175:diagnosis* / Q000453:epidemiology* / Q000473:pathology; D015179:Colorectal Neoplasms / Q000453:epidemiology*; D015897:Comorbidity; D003625:Data Collection; D004240:Diverticulum / Q000175:diagnosis* / Q000453:epidemiology* / Q000473:pathology; D006801:Humans; D015995:Prevalence; D011446:Prospective Studies; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D014408:Biomarkers, Tumor