Indian Journal of Pathology and Oncology


A morphometric analysis of diameter of blood vessels in relation to degree of eosinophils and basophils (mast cells) infiltration for analysis of severity and prognosis of acute appendicitis


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Author Details: Bharati Bhushan Chittawadgi, Sagar Chandrakant Mhetre, Bhusan Basavaraj Chittawadgi

Volume : 3

Issue : 3

Online ISSN : 2394-6792

Print ISSN : 2394-6784

Article First Page : 463

Article End Page : 469


Abstract

Background: Acute appendicitis is the most common surgical emergency that affect about 7% of the population. Obstruction of the lumen by faecoliths is the usual cause of acute appendicitis. The histopathologic stages of appendicitis are important to regarding prognosis. Study of diagnostic accuracy and pathological correlation aiming to reduce not only late complications but also the rate of negative appendicectomies had been studied worldwide.
Application of quantitative microscopic techniques for assessing the diagnosis of inflammatory condition of appendix is quite useful since it imparts objectivity and reliability to the diagnosis. This is the first study we carried out for analysis of severity of acute appendicitis by morphometric measurement of diameter of blood vessels in relation to degree of eosinophil and basophil (mast cells) infiltration.
Materials and Methods: A retrospective review of archives of the department of pathology, for the period of three years from 2010 to 2012, we identified 100, clinically and histopathologically diagnosed cases of acute appendicitis.
Slides and blocks were selected for the study. Blood vessel morphometric analysis was performed on H and E stained sections. Diameter of one largest measuring blood vessel in each layer (Mucosa, Muscularis propria, Submucosa and serosa) of the appendix, is measured by using ProGres Capture Pro software. Mean and SD of the diameters of the blood vessels in each layer of appendix in 100 specimens were calculated.
Number of eosinophils infiltration/10 hpf on H & E stained sections and number of mast cells infiltration/10 hpf on Toluidine blue stained sections in each layer of appendix in 100 specimens were counted by using light microscopy.
Results: All 100 patients, who underwent operative procedure, came with chief complaint of pain in the periumbilical region migrating to the right iliac fossa. The mean age of presentation was 25.10 years.
This study found that as there is increase in the number of eosinophils (counted as number of eosinophils/10 hpf) in each layer of appendix, there is decrease in the diameter of blood vessel in corresponding layer of the same appendicectomy specimen and as there is increase in the number of mast cells (counted as number of mast cells/10 hpf) in each layer of appendix, there is also increase in the diameter of the blood vessel in corresponding layer of the same appendicectomy specimen in acute appendicitis.
Conclusion: The study establishes the statistical correlation between morphometry and degree of cellular inflammatory infiltrate (eosinophils and mast cells counted by using light microscopy) which helps to assess severity of inflammation of the appendix.

Keywords:
Acute Appendicitis, Morphometry