Multiple bee stings, peritumoral mast cell degranulation and anaphylaxis - Is there a relationship?

Jonathon Herbst, Karen Heath, Robert Heddle, J Gilbert, Roger Byard

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    6 Citations (Scopus)


    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.

    Original languageEnglish
    Pages (from-to)591-594
    Number of pages4
    JournalJournal of Forensic and Legal Medicine
    Issue number6
    Publication statusPublished - 2013


    • Anaphylaxis
    • Autopsy
    • Bee sting
    • Esophageal adenocarcinoma
    • Mast cells


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