Immunocytochemical identification of neuroendocrine markers in human cardiac paraganglion-like structures

Paraganglion-like structures (PLS) containing chromaffin-positive cells have been reported to be present in the adult human heart. The present work was initiated in order to evaluate the density of these structures in the interatrial septum and to study the presence of immunoreactivity of their cells to NSE and PGP 9,5 antibodies, two neuroendocrine markers. Six hundred 6-microns paraffin serial sections were obtained from the upper third of the interatrial septum from six adult human hearts. From 2 to 12 paraganglia were found in each case, and their principal cells stained positively with NSE and PGP 9,5 antibodies. Depending on how these PLS related to other cardiac structures, four different types were identified: Type I - "True paraganglia" (located adjacent to ganglia or nerve fibers); Type II - "Free paraganglia" (immersed in the interatrial adipose tissue, without evident connection to other structures); Type III - "Intraganglionic paraganglia" (located within the nervous ganglia); Type IV - "Intramyocardic paraganglia" (small nests of immunoreactive cells closely related to myocardiocyte bundles). These cardiac paraganglia, which probably belong to the visceral-autonomic group, may have a role in the regulation of the cardiac function and in the adaptive mechanisms of the heart. Its is also possible that they originate functioning and non-functioning tumours.