Mast cell density and neuronal hypertrophy in patients with acute appendicitis.

In the gastrointestinal system, the relationship between the enteric nervous system and mast cells has been described in normal and pathological conditions. However, a few studies have evaluated the association between the numbers of mast cells and the enteric nervous system in acute appendicitis. The aim of this study was to immunohistochemically investigate the relationship between mast cell density and the enteric nervous system in cases with clinically and histopathologically diagnosed acute appendicitis and in normal appendices. Twenty-five patients with acute appendicitis and 12 cases with normal appendices were included in our study. Mast cell tryptase and PGP 9.5 immunostained tissue sections were subjected to quantitative image analysis. Our results showed that mast cell density, number of Schwann cells and the number and size of ganglia were significantly greater in acute appendicitis than in the control group (p<0.05). A strong correlation between mast cell density and neuronal proliferation and hypertrophy was detected only in cases with acute appendicitis. We failed to detect any relationship between mast cell density and neural components in the control group. Our findings indicate that mast cells could be one of the important cell populations responsible for nerve proliferation and hypertrophy in clinically and histopathologically diagnosed acute appendicitis.