The incidence and pattern of thyroid diseases in Saudi Arabia are not well known due to the lack of a national registry. Few studies were reported describing the pattern from non-mountainous regions of Saudi Arabia. [1][2][3][4] Asir is a high altitude territory and the pattern of thyroid diseases might be different. Indeed, we were struck by the unexpectedly high prevalence of malignancy in patients who underwent thyroidectomy for presumably benign goiter. We therefore decided to conduct this review in order to evaluate the pattern of surgically treated thyroid disease in the Asir area and compare it with other studies. Patients and MethodsAsir Central Hospital (ACH) is a referral hospital for the Asir Region of Saudi Arabia. The Department of Pathology at ACH is the main central laboratory, which receives specimens from 17 peripheral hospitals in the area. Over a period of six-and-one-half years, from January 1987 through June 1993, 361 thyroid specimens were received. The histopathological reports together with the age, sex, and nationality of the patients were reviewed. Statistical analysis was conducted using the SPSS/PC+ software package. Chi-square and Student's t-test were used at the 5% level of significance. ResultsAmong the 361 cases studied, 255 (70.6%) were Saudi nationals. The causes of goiter in surgically treated patients is shown in Table 1. The ages ranged from seven to 120 years (mean = 35.9±.13.8 years). Female patients constituted 81.7% of this series and the female to male ratio was 4.5:1. Multinodular goiter and adenoma (solitary nodule) constituted 68.3% of the cases, the latter being more common in young females (P<0.05). Toxic goiter was seen in 7.7% of patients and all of them either failed to respond or had recurrence after cessation of medical treatment. Autoimmune thyroiditis was seen in 23 (6.4%) patients, 16 of whom had Hashimoto thyroiditis (all except one were females) and the remaining seven patients had lymphocytic thyroiditis (two were males). In this series, there were three male patients (two Saudis and one Sudanese) who were diagnosed as dyshormonogenesis on the basis of high serum thyroid stimulating hormone (TSH) and diffuse hyperplasia on histopathological examination.Thyroid malignancy was found in 47 (13%) patients and the papillary carcinoma was the most common (65.9%) followed by thyroid lymphoma (21.3%); these findings are compared with other studies in Table 2. Four patients (40%) with lymphoma had an associated Hashimoto thyroiditis. The female to male ratio in patients with lymphoma was 4:1, the age range was 45 to 120 years (mean = 68.3 ± 22.3 years) and all were non-Hodgkin lymphoma.

This is a retrospective study involving 4708 consecutive appendix specimens removed over a period of 6.5 years for a clinical diagnosis of acute appendicitis, 64 (1.3%) of which showed histological evidence of schistosomiasis. Thirty-four schistosomal appendicitis (SA) cases were compared with 68 non-schistosomal appendicitis (NSA) cases admitted during the same period. SA patients were older in age, usually of male sex, mostly Egyptians and tended to have a higher hemoglobin and a lower leukocyte count ( P<0.05). Other features were not significantly different. It is concluded that, despite these differences, there are no reliable clinical or laboratory features by which SA can be predicted preoperatively. The majority of the studied patients were either discharged before the results of the histopathology study were ready and were lost to follow-up or the reports were overlooked. Therefore, we recommend that for all post-appendectomy patients living in or coming from endemic areas of schistosomiasis, the results of the histopathology study should be processed as early as possible and before the patient can be discharged so that the treatment can be commenced. Moreover, establishing a system by which infected patients could be traced and hence treated is highly recommended. Ann Saudi Med 1995;15(4): Schistosomal Appendicitis. 1995; 15(4): 347-349 The Asir region in the southwestern part of Saudi Arabia is an area endemic for schistosomiasis.1,2 We have observed that many surgically removed appendices show histological features of schistosomiasis and as such may be the only evidence of infestation of which many patients might not have been aware before appendectomy. The majority of those patients were difficult to trace when the histopathology report was available after discharge from the hospital. It would be essential that these patients receive antischistosomal therapy on this evidence alone to avoid further complications. We have therefore decided to review the records of patients with SA with the objective of identifying some clinical and/or laboratory criteria by which the disease can be distinguished from NSA so as to keep suspected SA patients in the hospital for a longer period to start treatment when the diagnosis is histologically confirmed. This communication reports on the results of the comparison which we carried out between SA and NSA. Patients and MethodsThe histopathological reports of 4708 appendices received in the Department of Pathology, Asir Central Hospital (ACH), Abha, Saudi Arabia from January 1987 through June 1993 were reviewed. This Department receives specimens from 17 hospitals in the area. SA was identified in 64 (1.35%) specimens. The records of 34 patients admitted to ACH were reviewed regarding age, sex, nationality, clinical presentation, relevant investigations, and the histopathology of the removed appendices. These were compared with a control group of NSA consisting of 68 patients who were admitted during the same period. The data were analyzed using SPSS/PC+ software pa...

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