TY - JOUR
T1 - Multiple bee stings, peritumoral mast cell degranulation and anaphylaxis - Is there a relationship?
AU - Herbst, Jonathon
AU - Heath, Karen
AU - Heddle, Robert
AU - Gilbert, J
AU - Byard, Roger
PY - 2013
Y1 - 2013
N2 - 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.
AB - 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.
KW - Anaphylaxis
KW - Autopsy
KW - Bee sting
KW - Esophageal adenocarcinoma
KW - Mast cells
UR - http://www.scopus.com/inward/record.url?scp=84885019684&partnerID=8YFLogxK
U2 - 10.1016/j.jflm.2012.09.016
DO - 10.1016/j.jflm.2012.09.016
M3 - Article
VL - 20
SP - 591
EP - 594
JO - Journal of Forensic and Legal Medicine
JF - Journal of Forensic and Legal Medicine
SN - 1752-928X
IS - 6
ER -