Appendiceal disease in hematopoietic cell transplantation

Abstract

Appendiceal diseases are rare reported complications during hematopoietic stem cell transplantation with no guidance on management in the published literature. Medical therapy may be considered in selected patients prior to surgical solutions.

Keywords: appendiceal disease; chemotherapy; hematopoietic stem cell transplant; immunocompromised; medical management.

FIGURE 1

Axial (top) and coronal (bottom) views of patient 1. Findings notable for large, dilated appendix with mucosal enhancement. Pathology post laparoscopic appendectomy revealed mucinous adenoma

FIGURE 2

Axial (top) and coronal (bottom) views of patient 2. Findings notable for enlarged appendix with inflammatory stranding throughout the right lower quadrant sparing the cecum and terminal ileum

FIGURE 3

Axial (top) and coronal (middle) views of patient 3. Findings notable for enlarged appendix is with a 7 mm stone likely in the distal lumen and a 4.0 × 2.7 cm phlegmonous region intimately involved with the distal appendix. Follow‐up axial image (bottom) on day +195 show resolution of inflammation and appendicolith

FIGURE 4

Axial (top) and coronal (bottom) views of patient 4. Findings notable for enlarged appendix with mesenteric fat stranding and terminal ileitis

FIGURE 5

Axial (top) and coronal (bottom) views of patient 5. Findings notable for extensive small bowel and colonic mucosal hyperenhancement with wall thickening involving the descending and sigmoid colon with focal inflammation at the splenic flexure. Dilated fluid‐filled appendix with mucosal hyperenhancement