Enterochromaffin Cells and Mast Cells in Acute Appendicitis

Background and Objective  Serotonin levels are increased in acute appendicitis. We investigated the possible source of this increase. The aim of this study was to compare the distribution and density of epithelial and nonepithelial enterochromaffin (EC) cells as well as numbers of degranulated and nondegranulated mast cells in different layers of normal appendices and acute appendicitis. Methods  Sections from 15 cases of acute appendicitis and 10 cases where the appendix was morphologically normal were stained with Hematoxylin & Eosin, Toluidine blue, and immunohistochemically for chromogranin and CD-117. EC cells stained by chromogranin were counted per crypt and extraepithelial EC cells counted and expressed as cells per unit area (mm ² ). Mast cells stained by Toluidine blue and CD-117 were counted in lamina propria, submucosa, and muscle layers. The difference between Toluidine blue and CD117 stained mast cells was taken to be an estimate of degranulated cells. The cell counts were expressed per unit area (mm ² ) as well as per cross-sectional area of the appendix. Results  There was no statistically significant difference in epithelial and extraepithelial EC cells between acute appendicitis and normal appendix. Estimated mast cell degranulation as indicated by mast cell counts per cross-sectional area is greatly increased in acute appendicitis when compared with normal. Conclusion  Degranulated mast cells rather than EC cells may be the main source of raised serotonin in acute appendicitis.