Mast cell density in cardio-esophageal mucosa.
Mast cells are related to certain gastrointestinal complaints. Mast cell density has not been studied in cardio-esophageal region to the best of our knowledge. In this study we wanted to obtain an estimate of mast cell density in this region and compare it with mast cell density in antrum. From April 2007 till March 2010, we chose children (<14 years old) who underwent upper endoscopy and from whom the taken biopsy was stated to be from lower third of esophagus, but in microscopic examination either cardio- esophageal mucosa or only cardiac mucosa was seen. Mast cells were counted by Giemsa stain at × 1000 magnification in 10 fields. 71 children (<14 years old) were included in this study of which, 63.4% (n=45) were female and 36.6% (n=26) were male. The mean age of patients was 7.20 ± 4.21 years (range: 0.2 -14 years). The most common clinical manifestations were recurrent abdominal pain (64.8%) and vomiting (23.9%) followed by symptoms of gastro-esophageal reflux disorder, poor weight gain, hematemesis and dysphagia. The mean mast cell density in the cardiac mucosa was 33.41 ± 32.75 in 0.25 mm2 (range: 0-155), which was two times of that in antral mucosa. We found a significant but weak positive correlation at the 0.05 level between mast cell density of cardiac mucosa and the antrum. Higher mast cell counts were seen in cardiac mucosa in this study. Significant positive correlation between mast cell density of cardiac mucosa and the antrum could hint to a single underlying etiology for the inflammatory process in gastro- esophageal junction and gastric mucosa.
1. Hayward J. The lower end of the esophagus. Thorax 1961;16:36–41.
2. Chandrasoma PT, Der R, Ma Y, Dalton P, Taira M.Histology of the gastroesophageal junction; an autopsy study. Am J Surg Pathol 2000; 24(3):402–9.
3. Chandrasoma P. Pathological basis of gastroesophageal reflux disease. World J Surg 2003; 27(9):986–93.
4. Jamieson JR, Stein HJ, DeMeester TR, Bonavina L, Schwizer W, Hinder RA, et al. Ambulatory 24-hour esophageal pH monitoring: normal values, optimal thresholds, specificity, sensitivity, and reproducibility. Am J Gastroentero 1992; 87(2):1102–11.
5. Liacouras CA, Spergel JM, Ruchelli E, Verma R, Mascarenhas M, Semeao E, et al. Eosinophilic Esophagitis: A 10-Year Experience in 381 Children. Clin Gastroenterol Hepatol 2005; 3(12):1198-206.
6. Purdy JK, Appelman HD, Golembeski CP, McKenna BJ.Lymphocytic esophagitis: a chronic or recurring pattern of esophagitis resembling allergic contact dermatitis. AM J Clin Pathol 2008; 130(4):508-13.}
7. Nakajima S, Krishnan B, Ota H, Segura AM, Hattori T, Graham DY, et al. Mast cell involvement in gastritis with or without Helicobacter pylori infection. Gastroenterology 1997; 113(3):746–54.
8. Sulik A, Kemona A, Sulik M, Ołdak E. Mast cell in chronic gastritis of children. Pol Merkuriuzc Lek 2001;10(57):156-60.9. Mahjoub FE, Hassanbeglou B, Pourpak Z, Farahmand F, Kashef N, Akhlaghi AA. Mast cell density in gastric biopsies of pediatric age group and its relation to inflammation and presence of Helicobacter pylori. Diagn Pathol 2007; 2:14.
10. Mahjoub FE, Farahmand F, Pourpak Z, Asefi H, Amini Z.Mast cell gastritis: Children complaining of chronic abdominal pain with histologically normal gastric mucosal biopsies except for increase in mast cells, proposing a new entity. Diagn Pathol 2009; 4:34.