Distribution of Mast Cell in Acute Appendicitis and Its Role in Histopathological Diagnosis - A Study in Tertiary Care Centre from South India
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. KEYWORDS Appendicitis, Histologically Negative Acute Appendicitis, Mast Cells, Toluidine Blue, CD 117