Amebic granuloma of the appendix is a complication of chronic colitis caused by Amoeba histolytica. The clinical presentation is usually limited abdominal pain and intermittent diarrhea, sometimes positive for occult blood in the stool, and a soft, salami-like mass may be palpable in the right lower abdomen. What is the main differential diagnosis of amebic granuloma of the appendix? 1.Sarcoidosis of the cecum Because the lesion does not heal for a long time, it produces a large amount of fibrous tissue, inflammatory infiltration and edema of the intestinal mesentery and intestinal wall, and forms a granuloma-like mass, and causes intestinal obstruction due to narrowing of the intestinal lumen or movement disorder of the intestinal wall. 2. Schistosomiasis granuloma of the ileocecal region is a result of the rupture of the small veins in the intestinal wall, where the eggs of schistosomes enter the intestinal wall tissue around the vessels, especially the submucosa. The eggs cause leukocytic infiltration in the intestinal wall, pseudonodular formation, fibrous tissue proliferation, and late fibrotic thickening of the intestinal wall and mucosal proliferation to form granulomas. Common symptoms are mostly seen in young adults with a history of amoebic dysentery and systemic manifestations such as fever, wasting, and anemia. There is abdominal pain as persistent vague or distending pain in the right lower abdomen and around the umbilicus, and some patients may have paroxysmal abdominal pain with abdominal distention and vomiting. It may be seen as increased frequency of stools, thin paste-like stools, variable frequency, dark red jam-like color and foul odor. A mass may be palpable in the right lower abdomen with unclear borders, pressure pain, medium texture, and inability to push, with intestinal shape and peristaltic waves visible in the abdomen and active or hyperactive bowel sounds.