Mast cells in the GI tract: How many is too many? (Part seven)
The 2014 Doyle paper provides mast cell counts in colon biopsies for healthy controls, MCAS, and IBS. Mast cells were identified using antibodies for tryptase, CD117, CD25 and CD30 (IHC). Mast cells were counted in both one HPF in the densest portion of the slide and in five HPF and averaged. In the densest portion of the slide, mast cell counts were higher in 1 HPF than in the average of 5 HPF. Differences in methodology such as this can contribute to lack of consensus on what constitutes too many mast cells. See Table 21 for details.
|Table 21: Comparison of mast cell count in 1 HPF and in the average of 5 HPF|
|Doyle LA, et al. A clinicopathologic study of 24 cases of systemic mastocytosis involving the gastrointestinal tract and assessment of mucosal mast cell density in irritable bowel syndrome and asymptomatic patients. Am J Surg Pathol 2014; 38 (6): 832-843.|
|Microscopy method: 400x magnification, mast cells counted in 1 hpf|
|Visualization: IHC for tryptase, CD117, CD25 and CD30|
|HPF||Control group A:
|Control group B:
|Control group C:
|Average of 5 hpf||19 mast cells/hpf||7-39 mast cells/hpf||20 mast cells/hpf||12-31 mast cells/hpf||23 mast cells/hpf||9-45 mast cells/hpf|
|1 hpf||26 mast cells/hpf||11-55 mast cells/hpf||28 mast cells/hpf||14-48 mast cells/hpf||30 mast cells/hpf||13-59 mast cells/hpf|
Other papers also investigated factors that could contribute to differences in mast cell counts. The 2015 Sethi paper evaluated differences in GI mast cell counts between men and women. Women had marginally higher counts in both IBS and control groups. See Table 22 for details.
|Table 22: Difference in mast cell count between men and women with chronic diarrhea and asymptomatic controls|
|Sethi A, et al. Performing colonic mast cell counts in patients with chronic diarrhea of unknown etiology has limited diagnostic use. Arch Pathol Lab Med 2015; 139 (2): 225-232.|
|Microscopy method: 400x magnification, mast cells counted in 5 hpf and averaged|
|Visualization: CD117 (IHC)|
|Sample type||Study group: Women||Study group: Men||Control group: Women||Control group: Men|
|30 mast cells/hpf||27-34 mast cells/hpf||27 mast cells/hpf||24-31 mast cells/hpf||24 mast cells/hpf||22-37 mast cells/hpf||21 mast cells/hpf||19-24 mast cells/hpf|
|Diffuse scattered cells, no clusters.||Diffuse scattered cells, no clusters.||Diffuse scattered cells, no clusters.||Diffuse scattered cells, no clusters.|
One paper looked at the difference in mast cell count in the rectum of healthy patients over the age of 55 and under. Please note that these counts were made using a much lower magnification than other papers in this series, so mast cell counts are not directly comparable. Mast cells were identified using antibodies to tryptase (IHC). See Table 23 for details.
|Table 23: Differences in GI mast cell count in healthy patients over and under 55 years of age.|
|Dunlop SP, et al. Age related decline in rectal mucosal lymphocytes and mast cells. European Journal of Gastroenterology and Hepatology 2004; 16(10): 1011-1015.|
|SPECIAL NOTE: THESE COUNTS WERE MADE AT HALF THE MAGNIFICATION OF OTHER PAPERS IN THIS SERIES. THESE MAST CELL COUNTS ARE NOT DIRECTLY COMPARABLE TO OTHER STUDIES.|
|200x magnification, number of hpf not explicitly stated, assumed mast cells counted in 1 hpf|
|Visualization: Tryptase (IHC)|
|Sample type||Study group: Healthy, over 55 years old||Study group: Healthy, under 55 years old||Control group B:
No control group
|40.5 ± 2.4 mast cells/hpf||51.7 ± 4.1 mast cells/hpf||N/A||N/A|
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