[Neurogenic appendicopathy -- a common disorder, seldom diagnosed (author's transl)]

Abstract

Over 5000 routine appendix specimens were examined at the Institute for Pathological Anatomy, Graz University, for the presence of neurogenic appendicopathy (n.a.). With light microscopy it was possible to differentiate intramucosal, finely vacuolated nerve proliferations and central neuromas (n.a. in the narrower sense), as well as neuromuscular proliferations in the submucosa. All three forms are considerably more common in females. A diagnosis of neurogenic appendicopathy was made in 17.9% of all cases. The disorder is uncommon in the first decade of life, more common in the second decade, and, after the age of 45, is diagnosed histologically in a scant half of the cases. Clinically, n.a. cannot be distinguished with certainty from purulent or chronic recurrent appendicitis; leukocytosis and fever are also not sure criteria for a differential diagnosis. N.a. in the narrower sense is frequently accompanied by vegetative symptoms (variable blood pressure, constipation and diarrhea, meteorism, sweating). These symptoms are probably caused by hormones produced by the endocrine cells which are present in abnormally large quantities in the epithelial tissue and especially in the mucous stroma. As neurogenic appendicopathy can, at present, be diagnosed only histologically, it is to be encouraged that all such material, even when macroscopically unremarkable, be so examined.