Distribution of Mast cell in uterine smooth muscle tumour - Anobservational Study in tertiary care centre

Abstract

Background: Uterine smooth muscle tumours (USMTs) constitute a heterogeneous group of neoplasms ranging from benign leiomyomas to malignant leiomyosarcomas. Mast cells are important components of the tumour microenvironment and may influence tumour behaviour through their role in inflammation, angiogenesis, and tissue remodelling.

Objectives: To evaluate mast cell distribution in various histopathological types of uterine smooth muscle tumours and to correlate mast cell density with tumour type and functional classification as per the WHO 2020 criteria.

Materials and Methods: This retrospective and prospective cross-sectional study was conducted in the Department of Pathology, Integral Institute of Medical Sciences and Research, Lucknow, over a period of eighteen months. A total of 100 hysterectomy and myomectomy specimens diagnosed as uterine smooth muscle tumours were included. Routine histopathological evaluation was performed using hematoxylin and eosin–stained sections. Mast cells were demonstrated using 1% toluidine blue staining and counted in ten non-overlapping high-power fields. Tumours were classified according to the WHO 2020 criteria. Statistical analysis was carried out using ANOVA, Chi-square test, and Kruskal–Wallis test, with p <0.05 considered significant.

Results: Leiomyoma was the most common diagnosis (85%). Mean mast cell count was significantly higher in benign tumours compared to malignant leiomyosarcomas (p <0.001). Angioleiomyoma showed the highest mast cell density, while leiomyosarcoma demonstrated the lowest. A statistically significant inverse association was observed between mast cell density and tumour aggressiveness based on the WHO functional order.

Conclusion: Mast cell density shows significant variation across uterine smooth muscle tumours and is higher in benign lesions than in malignant tumours. Mast cell assessment may provide valuable insight into tumour biology and serve as a useful adjunct in the evaluation of uterine smooth muscle tumours.