Unexpected Findings on Histology: Plant Seeds Inducing and Mimicking Gastrointestinal Diseases

TL;DR

Plant seeds can cause or mimic gastrointestinal diseases, leading to diagnostic challenges in histopathology.

Contribution

The paper presents two case studies highlighting the role of plant seeds in gastrointestinal pathology.

Findings

A plant seed was found to cause obstructive acute appendicitis in a child.

A tomato seed was mistaken for a colonic polyp during a colonoscopy.

Plant seeds can mimic pathological lesions and require recognition for accurate diagnosis.

Abstract

Foreign material is an uncommon finding in routine gastrointestinal histopathology, but may occasionally contribute to disease pathogenesis or create diagnostic pitfalls. We report two illustrative cases highlighting the diverse clinical and histologic implications of ingested plant material. The first case involves a 10-year-old boy who presented with clinical features consistent with acute appendicitis and underwent appendectomy. Although gross examination revealed a macroscopically unremarkable appendix, histological evaluation demonstrated mucosal ulceration associated with an impacted plant seed within the appendiceal lumen, supporting a diagnosis of obstructive acute appendicitis. The second case describes a 60-year-old woman undergoing a screening colonoscopy, during which a small sessile lesion in the transverse colon was resected. Histologic examination revealed no colonic mucosa; instead, the specimen consisted entirely of plant material, morphologically consistent with a tomato seed, representing an incidental finding mimicking a colonic polyp. These cases underscore that plant seeds, while rare, may act as obstructive agents in appendicitis or simulate true pathological lesions during endoscopic and histologic evaluation. Awareness of the characteristic microscopic features of plant material is essential to avoid misdiagnosis and to recognise their potential clinical and forensic relevance.

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