Pulse Granulomas in Interval Appendectomy Specimens: Histochemical Identification of Cellulose Matter

Pulse granuloma is a rare pathologic condition considered to be a benign inflammatory reaction to foreign materials originated from ingested legume matter. As for pulse granulomas of the gastrointestinal tract, association with diverticular diseases is relatively common, but only a few pulse granulo...

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Main Authors: Shinichi Ban, Akiko Fujii, Toshiro Takimoto, Kenta Kikuchi, Woodea Kang, Yukiko Namiki, Junichi Koyatsu, Yoshihiko Ueda
Format: Article
Language:English
Published: Karger Publishers 2018-12-01
Series:Case Reports in Gastroenterology
Subjects:
Online Access:https://www.karger.com/Article/FullText/495318
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spelling doaj-2a0fc0b4a0db40519516f17535e377572020-11-25T00:21:43ZengKarger PublishersCase Reports in Gastroenterology1662-06312018-12-0112376577210.1159/000495318495318Pulse Granulomas in Interval Appendectomy Specimens: Histochemical Identification of Cellulose MatterShinichi BanAkiko FujiiToshiro TakimotoKenta KikuchiWoodea KangYukiko NamikiJunichi KoyatsuYoshihiko UedaPulse granuloma is a rare pathologic condition considered to be a benign inflammatory reaction to foreign materials originated from ingested legume matter. As for pulse granulomas of the gastrointestinal tract, association with diverticular diseases is relatively common, but only a few pulse granuloma cases associated with appendicitis have been reported. This report presents histopathologic findings of pulse granuloma lesions observed in two appendectomy cases, with some histochemical examinations of cellulose matter which is reportedly a major component to provoke pulse granuloma reaction. Our patients in both cases were girls in their teens, and they underwent interval appendectomy for acute appendicitis. Both appendectomy specimens revealed ruptured walls with inflammatory granulation tissue with marked foreign body reaction including characteristic collections of ring-like, curled ribbon-like, and/or lobulated nephrosclerosis-like hyaline structures and various foreign bodies, in which microorganisms or amyloid deposition were not identified. The presence of cellulose matter was suggested by Sirius red stain, the IKI (iodine potassium iodide)-H2SO4 method, and birefringence by polarized light. Appendectomy materials due to acute appendicitis would include pulse granuloma reaction provoked by ingested materials with cellulose. Pathologists should be familiar with the concept and histopathologic features of pulse granulomas to avoid misinterpreting them as vascular lesions and/or amyloid deposition, or any infectious organisms.https://www.karger.com/Article/FullText/495318Pulse granulomaAppendixAppendicitisInterval appendectomyCellulose
collection DOAJ
language English
format Article
sources DOAJ
author Shinichi Ban
Akiko Fujii
Toshiro Takimoto
Kenta Kikuchi
Woodea Kang
Yukiko Namiki
Junichi Koyatsu
Yoshihiko Ueda
spellingShingle Shinichi Ban
Akiko Fujii
Toshiro Takimoto
Kenta Kikuchi
Woodea Kang
Yukiko Namiki
Junichi Koyatsu
Yoshihiko Ueda
Pulse Granulomas in Interval Appendectomy Specimens: Histochemical Identification of Cellulose Matter
Case Reports in Gastroenterology
Pulse granuloma
Appendix
Appendicitis
Interval appendectomy
Cellulose
author_facet Shinichi Ban
Akiko Fujii
Toshiro Takimoto
Kenta Kikuchi
Woodea Kang
Yukiko Namiki
Junichi Koyatsu
Yoshihiko Ueda
author_sort Shinichi Ban
title Pulse Granulomas in Interval Appendectomy Specimens: Histochemical Identification of Cellulose Matter
title_short Pulse Granulomas in Interval Appendectomy Specimens: Histochemical Identification of Cellulose Matter
title_full Pulse Granulomas in Interval Appendectomy Specimens: Histochemical Identification of Cellulose Matter
title_fullStr Pulse Granulomas in Interval Appendectomy Specimens: Histochemical Identification of Cellulose Matter
title_full_unstemmed Pulse Granulomas in Interval Appendectomy Specimens: Histochemical Identification of Cellulose Matter
title_sort pulse granulomas in interval appendectomy specimens: histochemical identification of cellulose matter
publisher Karger Publishers
series Case Reports in Gastroenterology
issn 1662-0631
publishDate 2018-12-01
description Pulse granuloma is a rare pathologic condition considered to be a benign inflammatory reaction to foreign materials originated from ingested legume matter. As for pulse granulomas of the gastrointestinal tract, association with diverticular diseases is relatively common, but only a few pulse granuloma cases associated with appendicitis have been reported. This report presents histopathologic findings of pulse granuloma lesions observed in two appendectomy cases, with some histochemical examinations of cellulose matter which is reportedly a major component to provoke pulse granuloma reaction. Our patients in both cases were girls in their teens, and they underwent interval appendectomy for acute appendicitis. Both appendectomy specimens revealed ruptured walls with inflammatory granulation tissue with marked foreign body reaction including characteristic collections of ring-like, curled ribbon-like, and/or lobulated nephrosclerosis-like hyaline structures and various foreign bodies, in which microorganisms or amyloid deposition were not identified. The presence of cellulose matter was suggested by Sirius red stain, the IKI (iodine potassium iodide)-H2SO4 method, and birefringence by polarized light. Appendectomy materials due to acute appendicitis would include pulse granuloma reaction provoked by ingested materials with cellulose. Pathologists should be familiar with the concept and histopathologic features of pulse granulomas to avoid misinterpreting them as vascular lesions and/or amyloid deposition, or any infectious organisms.
topic Pulse granuloma
Appendix
Appendicitis
Interval appendectomy
Cellulose
url https://www.karger.com/Article/FullText/495318
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