Syamini Chandrasekharapillai Leelamany1, Seena Abdul Vaheed Radhika Devi2
BACKGROUND
Appendicitis is the most common indication for intra-abdominal surgery,
especially in adolescents and young adults. In about 15 – 25 % of appendices
removed at surgery because of suspected symptoms, histological features of
acute appendicitis are absent. The cause of acute abdominal pain in these
patients can be due to mast cells which may play a role in pathogenesis of
appendicitis-like pain. Demonstration of mast cell in tissue can be done by
toluidine blue staining or immunohistochemistry (IHC) marker CD 117. We
wanted to evaluate whether the degree of distribution of mast cells has any
relation with clinical findings and evaluate its usefulness as a diagnostic marker
for histological diagnosis of acute appendicitis.
METHODS
This is a descriptive study done in 120 cases of appendicectomy specimens from
clinically diagnosed cases of acute appendicitis received in a tertiary care center
in South India in which 60 where histology positive and others were histology
negative. Mast cell distribution in each group was compared using toluidine blue
stain and CD 117. Collected data was entered in Microsoft excel and analysed
using the statistical software SPSS version 16.
RESULTS
Mast cell distribution was significant in all layers of histologically negative acute
appendicitis in comparison with histology positive cases. Mucosa has maximum
mast cells distribution.
CONCLUSIONS
Mast cells play an important role in the clinical symptoms of patients even when
there were no features of acute inflammation. In those cases, mast cells can be
demonstrated by simple toluidine blue staining or IHC markers. This is one of the
less studied areas, and the clinicopathological discrepancy can be solved by
giving mast cell distribution along with histopathology diagnosis.
