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Histochemical pattern in alimentary tract duplications of children
M Mathur1, S D Gupta, M Bajpai
1Department of Pathology, All India Institute of Medical Sciences, New Delhi.
Insights
Histological and histochemical analysis of pediatric alimentary tract duplication cysts reveals diverse mucosal linings and mucin profiles. Mucin composition correlates with patient age, with younger infants showing more complex mucin types.
Area of Science:
- Gastroenterology
- Pediatric Surgery
- Histopathology
Background:
- Alimentary tract duplication cysts are congenital anomalies with varied presentations.
- Understanding their histological and histochemical characteristics is crucial for diagnosis and management.
Purpose of the Study:
- To perform detailed histological and histochemical studies on pediatric alimentary tract duplication cysts.
- To investigate the types of mucosal lining and mucin composition within these cysts.
- To explore potential correlations between cyst characteristics and patient age.
Main Methods:
- Histological examination of 12 pediatric alimentary tract duplication cysts.
- Histochemical staining using Periodic Acid-Schiff (PAS), Alcian Blue-PAS (AB-PAS), and high-iron diamine-Alcian Blue (HID-AB).
- Analysis of mucosal lining and mucin profiles (neutral, sulphomucins, sialomucins).
Main Results:
- Eleven cysts were lined by gastric mucosa; one also contained small intestinal and bronchial wall mucosa.
- One rectal cyst was lined with primitive rectal mucosa.
- Mucin histochemistry varied: three cysts showed neutral mucins, three showed neutral and focal sulphomucins, and five showed neutral, sulpho-, and sialomucins.
- A correlation was observed between mucin type and patient age.
Conclusions:
- Pediatric alimentary tract duplication cysts exhibit diverse histological and mucin phenotypes.
- Mucin histochemistry in gastric mucosal linings of these cysts changes with age.
- Younger infants (<1 month) present with a more complex mix of mucins, while older children (≥7 months) show predominantly neutral or sulphomucins.
Abstract:
Detailed histological and histochemical studies using PAS, AB-PAS, and high-iron diamine-AB were done on 12 alimentary tract duplication cysts in children. Nine of these were thoracic and three were abdominal in location. A total of 11 cysts (nine thoracic and two abdominal cysts) were lined by gastric mucosa seen in varying stages of maturation. One triloculated cyst had, in addition, small intestinal mucosa and bronchial wall mucosa. One intra-mucosal rectal cyst was lined exclusively with primitive rectal mucosa. The cysts showed a variable pattern of mucin histochemistry. In three cysts, the gastric mucosa showed neutral mucins. In another three cysts, in addition to neutral mucins, focal positivity for sulphomucins was observed in the apical region of the surface epithelial cells. In the remaining five cysts, the gastric mucosa showed neutral mucins along with a variable mixture of sulpho- and sialomucins. A correlation was seen between mucin histochemistry and the age of the patient. Neutral mucins or focal positivity for sulphomucins was seen in patients aged 7 months or more, whereas a mixture of sulpho-, sialo-, and neutral mucins was identified in patients who were 1 month old, or less.