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Type: Journal article
Title: Multiple bee stings, peritumoral mast cell degranulation and anaphylaxis - is there a relationship?
Author: Herbst, J.
Heath, K.
Heddle, R.
Gilbert, J.
Byard, R.
Citation: Journal of Forensic and Legal Medicine, 2013; 20(6):591-594
Publisher: Churchill Livingstone
Issue Date: 2013
ISSN: 1752-928X
Statement of
Jonathon Herbst, Karen Heath, Robert Heddle, John D. Gilbert, Roger W. Byard
Abstract: A case of a 58-year-old with fatal anaphylaxis due to multiple bee stings is reported. Supportive evidence for anaphylaxis included post-mortem serum tests, which demonstrated a markedly elevated tryptase level and increased sensitivity to bees on radioallergosorbent test (RAST). At autopsy a previously undiagnosed esophageal adenocarcinoma involving the gastroesophageal (GE) junction was also identified. Histology of the tumor demonstrated significant numbers of mast cells, many of which were degranulating. Increased numbers of mast cells, as in mastocytosis, are known to predispose to an allergic sensitivity to Hymenoptera. The finding of a significant peritumoral mast cell population with degranulating forms in this case, therefore, raises the possibility that death due to anaphylaxis was contributed to by mast cell proliferation in an occult esophageal carcinoma.
Keywords: Autopsy; Anaphylaxis; Bee sting; Esophageal adenocarcinoma; Mast cells
Rights: Crown copyright © 2012 Published by Elsevier B.V. All rights reserved.
RMID: 0020131443
DOI: 10.1016/j.jflm.2012.09.016
Appears in Collections:Pathology publications

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