{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T10:26:12Z","timestamp":1777890372232,"version":"3.51.4"},"reference-count":23,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Reactive lymphoid hyperplasia (RLH) is frequently identified in pediatric appendectomy specimens performed for suspected acute appendicitis. However, its associated neural and stromal alterations remain incompletely characterized.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective descriptive study evaluated pediatric appendectomy specimens obtained between January 2019 and January 2024. RLH cases were identified based on histopathological criteria. Archived specimens were re-evaluated using hematoxylin and eosin staining, S-100 immunohistochemistry, and Masson's trichrome staining. Neural alterations were classified according to H\u00f6fler's criteria, and fibrosis was graded semiquantitatively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 468 appendectomies, 100 cases fulfilled the criteria for RLH. The mean age was 11.34\u2009\u00b1\u20094.31 years, and 63% were male. Neural and stromal alterations, including S-100\u2013positive nerve elements and varying degrees of fibrosis, were frequently observed. H\u00f6fler Type 1 and Type 3 patterns were the most common, and fibrosis was predominantly mild to moderate. Postoperative symptom resolution was observed in patients with available follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>RLH in children is commonly associated with reactive neural and stromal alterations. However, these findings should be interpreted as nonspecific reactive changes rather than disease-specific features. Further studies are needed to clarify their clinical significance.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fped.2026.1749724","type":"journal-article","created":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T05:36:23Z","timestamp":1777613783000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Reactive lymphoid hyperplasia of the appendix in children: a descriptive analysis of accompanying neural and stromal features"],"prefix":"10.3389","volume":"14","author":[{"given":"Neslihan","family":"Gulcin","sequence":"first","affiliation":[{"name":"Department of Pediatric Surgery, University of Health Sciences, Umraniye Training and Research Hospital","place":["Istanbul, T\u00fcrkiye"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ilkay","family":"Tosun","sequence":"additional","affiliation":[{"name":"Department of Pathology, University of Health Sciences, Umraniye Training and 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