Mast cell profile in Benign Prostatic Lesions

Abstract

Background: The role of mast cells may be influenced by its location in the lesion. In the present study, the number and distribution of mast cells in both benign prostatic lesions were recorded. Materials & Methods: Prostatic chips obtained by transurethral resection of the prostate (TURP) and open prostatectomy specimens were included in this study, irrespective of age and clinical diagnosis. After adequate fixation over a period of 24 to 48 hours, samples were subjected to detail gross examination i.e. colour, consistency, weight, volume, presence of nodules, appearance on cut section etc. and representative tissue bits of TURP and prostectomy were taken for processing, based on criteria mentioned in Ackerman. H&E stained sections were studied in detail and lesions were categorized as inflammatory, non-infalmmatory, neoplastic or nonneoplastic pathology. After staining with 1% aqueous Toluidine Blue stain sections were initially checked under 4X and 10X objectives for staining characteristics and to select the proper area; then the sections were examined at 400X magnification (high power) in random 10 non overlapping high power fields for counting, distribution, morphology (either degranulated or intact), shape of mast cells. Results: This study includes 92 cases of prostate lesions. There were 88 cases (95.8%) of benign prostatic hyperplasia and rest all four were malignant lesions (4.2%). Mean age of the study population was 66.86 years. Majority of cases (39.1%) were in 7th decade and least number of cases (4.4%) was observed in 5^th decade. About 98.9% specimens were procured by TURP in multiple bits. Among 88 nodular hyperplasia cases 82.9% presented with prostatitis. Mast cell quantification revealed a mean mast cell count of 5.42 in10 HPF. There was no significant difference of distribution of mast cells in between various nodular hyperplasia specimens relative to glandular and stromal component of specimens. Mean mast cell count in nodular hyperplasia was 5.5/10 HPF. On statistical analysis mast cell density in NH without prostatitis versus NH with prostatitis, result was non-significant (P value=0.498). Conclusion: This study shows the variations in mast cell distribution in commonly encountered prostatic lesions. There is paucity of such studies in the literature and the possible utility of mast cell count to differentiate malignant from benign and atypical conditions needs further evaluation.