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Mast cells in cutaneous tumors: innocent bystander or maestro conductor?

Authors

  • Asok Biswas MD, FRCPATH, DIPRCPATH,

    1. Department of Pathology, Western General Hospital, Edinburgh, UK
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  • Joanna E. Richards BA,

    1. Dermatopathology Section, Department of Dermatology, Boston University School of Medicine, Boston, MA, USA
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  • Joseph Massaro PhD,

    1. Department of Biostatistics, Boston University School of Medicine, Boston, MA, USA
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  • Meera Mahalingam MD, PhD, FRCPATH

    Corresponding author
    1. Dermatopathology Section, Department of Dermatology, Boston University School of Medicine, Boston, MA, USA
    • Correspondence

      Meera Mahalingam, md, phd, frcpath

      Dermatopathology Section

      Department of Dermatology Boston

      University School of Medicine

      609 Albany Street

      J-301, Boston, MA 02118, USA

      E-mail: mmahalin@bu.edu

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  • Conflicts of interest: None.
  • Presented in part at the 47th Annual Meeting of the American Society of Dermatopathology, October 7–10, 2010, Atlanta, GA, USA.

Abstract

Background

Evidence favoring a critical role for mast cells (MC) in cutaneous malignancies is conflicting.

Methods

Using the immunohistochemical stain tryptase, MC counts were performed in the following tumor categories: epithelial (basal cell carcinoma [BCC]: nodular [N], n = 10, infiltrative [I], n = 10; squamous cell carcinoma [SCC]: well differentiated [W], n = 9, moderate/poorly differentiated [MP], n = 15); melanocytic (intradermal nevus, n = 10, malignant melanoma in situ [MMIS], n = 8, invasive melanoma, n = 15); vascular (hemangioma [HEM], n = 11, Kaposi's sarcoma [KS], n = 14, angiosarcoma [AS] n = 8); and fibrohistiocytic (dermatofibroma [DF], n = 7, atypical fibroxanthoma [AFX], n = 5, dermatofibrosarcoma protuberans [DFSP], n = 5). MC (intra- and peritumoral) were expressed as cells per 10 high-power fields.

Results

Mean MC counts were: BCCN 166.30; BCCI 130; SCCW 167.22; SCCMP 133.80; nevus 156.40; MMIS 93; MM radial growth phase 73.86; MM vertical growth phase 82.13; HEM 165.18; KS 120.57; AS 168.13; DF 247.86; AFX 280.20; and DFSP 83.60. Using a one-way analysis of variance, statistically significant differences were observed in the following pairs: AFX and DF vs. DFSP, nevus vs. melanoma, AS and HEM vs. KS.

Conclusions

Our findings appear to point towards a dichotomous role for mast cells in fibrohistiocytic and vascular neoplasms and argue against their preferential recruitment in epithelial malignancies and malignant melanoma. The value of mast cell counts as a prognostic index appears to be limited in most cutaneous malignancies.

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