20Jan 2020

CYTOKERATIN-POSITIVE SUBSEROSAL MYOFIBROBLASTS IN PERFORATED ACUTE APPENDICITIS : A CASE REPORT AND LITERATURE REVIEW

  • Pathology Department, Mohamed VI University Hospital, Oujda, Morocco.
  • General Surgery, Mohamed VI University Hospital, Oujda, Morocco.
  • Abstract
  • Keywords
  • References
  • Cite This Article as
  • Corresponding Author

In the normal appendix, myofibroblasts are found as normal cells in the mucosal pericryptal region. These cells play an important role in organogenesis and wound healing. We report the case of a 7 years old boy, who was admitted for an acute perforated appendicitis. An appendicectomy was performed with revelation of an appendiceal wall perforation. Histological examination of the appendicectomy specimen is performed. Samples taken from the area of perforation showed large number of moderately atypical spindle or stellate-shaped cells with large hyperchromatic nuclei with some observed multinucleations. Cytoplasm is often elongated and eosinophilic. Some rare mitotic figures were present. These cells express pancytokeratin and SMA, with no expression of H-caldesmon. In case of perforated acute appendicitis, cytokeratin- and SMA-positive myofibroblasts are observed in the subserosa. There are several theories trying to explain the origin of subserosal myofibroblastes. One theory postulates that these cells could originate from CD34 positive stromal cells, a second one links these cells to mesothelial cells and recently, it is believed that submesothelial cell could be the origin.


  1. Nakayama H, Enzan H, Miyazaki E, Kuroda N, Naruse K, Kiyoku H, Hiroi M (2000) Myofibroblasts at the tumor border of invasive gastric carcinomas: with special reference to histological type and tumor depth. Oncol Rep 7:1011?1015
  2. Nakayama H, Enzan H, Miyazaki E, Naruse K, Kiyoku H, Hiroi M (1998) The role of myofibroblasts at the tumor border of invasive colorectal adenocarcinomas. Jpn J Clin Oncol 28:615?620
  3. Kuroda N, Toi M, Nakayama H, Miyazaki E, Yamamoto M, Hayashi Y, Hiroi M, Enzan H (2004) The distribution and role of 
myofibroblasts and CD34-positive stromal cells in normal pancreas and various pancreatic lesions. Histol Histopathol 19:59?67
  4. Barth PJ, Ramaswamy A, Moll R (2002) CD34fibrocytes in normal cervical stroma, cervical intraepithelial neoplasia III, and invasive squamous cell carcinoma of the cervix uteri. Virchows Arch 441:564?568
  5. Kuroda N, Nakayama H, Miyazaki E, Hayashi Y, Toi M, Hiroi M, Enzan H (2004) Distribution and role of CD34-positive stromal cells and myofibroblasts in human normal testicular stroma. Histol Histopathol 19:743?751
  6. Kuroda N, Miyazaki E, Hayashi Y, Toi M, Hiroi M, Enzan H (2004) The disappearance of CD34-positive and alpha-smooth muscle actin-positive stromal cells associated with human intra-uterine and tubal pregnancies. Histol Histopathol 19:707?713
  7. Powell DW, Mifflin RC, Valentich JD, Crowe SE, Saada JI, West AB (1999) Myofibroblasts. II. Intestinal subepithelial myofibroblasts. Am J Physiol 277 (Cell Physiol 46):C183?C201
  8. Powell DW, Mifflin RC, Valentich JD, Crowe SE, Saada JI, West AB (1999) Myofibroblast. I. Paracrine cells important in health and disease. Am J Physiol 277 (Cell Physiol 46):C1?C19
  9. Pitt MA, Haboubi NY (1995) Serosal reaction in chronic gastric ulcers: an immunohistochemical and ultrastructural study. J Clin Pathol 48:226?228
  10. Adegboyega PA, Mifflin RC, DiMari JF, Saada JI, Powell DW (2002) Immunohistochemical study of myofibroblasts in normal colonic mucosa, hyperplastic polyps, and adenomatous colorectal polyps. Arch Pathol Lab Med 126:829?836
  11. Jimenez-Heffernan JA, Aguilera A, Aroeira LS, Lara-Pezzi E, Bajo MA, del Peso G, Ramirez M, Gamallo C, Sanchez-Tomero JA, Alvarez V, Lopez-Cabrera M, Selgas R (2004) Immunohis- tochemical characterization of fibroblast subpopulations in normal peritoneal tissue and in peritoneal dialysis-induced fibrosis. Virchows Arch 444:247?256
  12. Chauhan H, Abraham A, Phillips JRA, Pringle JH, Walker RA, Jones JL (2003) There is more than one kind of myofibroblasts: analysis of CD34 expression in benign, in situ, and invasive breast lesions. J Clin Pathol 56:271?276
  13. Hamauzu, T., Kuroda, N., Guo, L., Miyazaki, E., Hayashi, Y., Toi, M., & Enzan, H. (2006). CAM5. 2-positive subserosal myofibroblasts in appendicitis.?Medical molecular morphology,?39(4), 209-213.
  14. Adegboyega PA, Mifflin RC, DiMari JF, Saada JI, Powell DW (2002) Immunohistochemical study of myofibroblasts in normal colonic mucosa, hyperplastic polyps, and adenomatous colorectal polyps. Arch Pathol Lab Med 126:829?836
  15. Brittan M, Hunt T, Jeffery R, Poulsom R, Forbes SJ, Hodivala- Dilke K, Goldman J, Alison MR, Wright NA (2002) Bone marrow derivation of pericryptal myofibroblasts in the mouse and human small intestine and colon. Gut 50:752?757
  16. Bolen JW, Hammar SP, McNutt MA (1986) Reactive and neo- plastic serosal tissue. A light-microscopic, ultrastructural, and immunocytological study. Am J Surg Pathol 10:34?47
  17. Amari M, Taguchi K, Iwahara M, Naoe S, Takahashi K (2004) Immunohistochemical and ultrastructural studies of the effects of predonisolone on transformation of fibroblasts to regenerated mesothelial cells. Med Electron Microsc 37:242?251.

[Achraf Miry, Elmehdi Tiabi, Amal Bennani, Fatima-Zahra Rahou and Mohamed Bouziane (2020); CYTOKERATIN-POSITIVE SUBSEROSAL MYOFIBROBLASTS IN PERFORATED ACUTE APPENDICITIS : A CASE REPORT AND LITERATURE REVIEW Int. J. of Adv. Res. 8 (Jan). 607-611] (ISSN 2320-5407). www.journalijar.com


Dr Achraf Miry
Pathology department, Mohamed VI university hospital, Oujda, Morocco.

DOI:


Article DOI: 10.21474/IJAR01/10337      
DOI URL: https://dx.doi.org/10.21474/IJAR01/10337