Role of mast cells and neuronal hypertrophy in acute appendicitis

Acute appendicitis is a common surgical emergency. Appendix continues to be the major chunk of surgical specimens received in Pathology laboratory. However, pathogenesis of appendicitis remains poorly understood. Obstruction and inflammation is implied in pathogenesis of acute appendicitis. Presently there is increasing evidence of involvement of enteric nervous system in immune regulation and in inflammatory responses. The present study combines routine histopathology and immunohistochemistry to study the role of mast cells and enteric nervous system in pathophysiology of acute appendicitis. We have done a prospective study for a period of one and half years from January 2014 to July 2015. Appendicectomy specimens from patients who are clinically diagnosed as acute appendicitis were included in study group as cases. Appendix specimens removed at Forensic autopsies were used as controls. Study was conducted on total 138 appendix specimens of which 118 were surgically removed from patients with acute appendicitis, taken as study group. 20 specimens from Forensic autopsy, were used as comparison group (normal control group). We found a consistent increase in mast cell and neuronal counts along with prominence of ganglion cells in specimens with acute appendicitis compared to the control group.