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General and Systemic Histopathology, C601&C602
     
    Slide 139: Acute Appendicitis
    Here you have two sections of the appendix.  The one on the left is a longitudinal section in which the lumen is not well defined.  It contains lots of necrotic debris.  The section on the right is a little easier to understand as a hollow organ. Still the lumen is partially obliterated by necrotic debris and inflammatory material. 

    Start reviewing this slide in the lumen and work your way methodically  to the serosal surface.  Pay attention to all the elements and make notes on what you see. 

    See this slide with the virtual microscope.

    In this slide, the mucosa of the appendix is largely missing and there is a profound acute inflammatory infiltrate in the lamina propria. There is also a lot of necrotic debris in the lumen of the organ. This is a difficult slide because the acute inflammatory infiltrate is intermixed with the normally occurring lymphoid tissue of the appendix. Remember that in the healthy state you would find many lymphoid aggregates in the lamina propria of the appendix, and throughout the length of the bowel for that matter. You may also see some newly forming granulation tissue on the serosal surface. As far as that goes, your best shot at seeing the constituents of the acute infiltrate will be in the serosal surface itself. In some of the slides there is marked lymphoid hyperplasia in the lamina propria (a finding you might expect), so it is probably best to steer away from lumen and the centrally located portions of this tissue for right now.


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