LYMPHOID HYPERPLASIA OF THE APPENDIX: WITH A NOTE ON ITS ROLE IN ACUTE APPENDICITIS

In the routine examination of appendixes removed at operation we were impressed by the unusual richness of the lymphoid tissue as the prominent histologic feature in a group of cases presenting the clinical syndrome of a mildly acute, subacute or recurrent appendicitis. Our studies led us to believe that hyperplasia of lymphoid tissue, either focally or diffusely, may cause sufficient obstruction in the narrowlumened appendix to produce symptoms simulating appendicitis. Furthermore, in reviewing a series of cases of pathologically early acute appendicitis, we felt that here, too, the hyperplasia of the lymphoid tissue might be a factor of prime etiologic importance.

Lymphoid hyperplasia of the appendix has been described by Wätzgold,¹ Klemm,² Miloslavich,³ Stout,⁴ Moschcowitz,⁵ Barss,⁶ Symmers and Greenberg⁷ and Smith.⁸ Most of these investigators considered it a phase of status lymphaticus. Smith thought that it constituted a definite clinical entity.

Since