title: The Density of Interstitial Cells of Cajal Is Diminished in Choledochal Cysts.
abstract: OBJECTIVE
  Interstitial cells of Cajal (ICC) have been shown to be present in the extrahepatic biliary tract of animals and humans. However, ICC distribution in choledochal cysts (CC) has not been investigated. A study was conducted to investigate the distribution of ICC in the extrahepatic biliary tract, including CC, in pediatric human specimens.
  
  
  METHODS
  The specimens were divided into two main groups as gallbladders and common bile ducts. Gallbladders were obtained from the cholelithiasis, CC operations and autopsies. Common bile ducts were obtained from autopsies. Tissues were stained using c-kit immunohistochemical staining. ICC were assessed semi-quantitatively by applying morphological criteria and were counted as the number of cells/0.24 mm(2) in each area under light microscopy.
  
  
  RESULTS
  A total of 35 gallbladders and 14 CC were obtained from operations. Ten gallbladders plus common bile ducts were obtained from autopsies. The mean numbers of ICC in the gallbladders of cholelithiasis and the gallbladders of CC were 12.2 ± 4.9 and 5.3 ± 1.2, respectively (p = 0.003). The mean numbers of ICC in the common bile ducts and CC were 9.8 ± 2.9 and 3.4 ± 1.4, respectively (p = 0.001).
  
  
  CONCLUSIONS
  The scarcity of ICC in the extrahepatic biliary tract may be responsible for the etiopathogenesis of the CC.
authors.affiliation: Department of Pediatric Surgery, Dokuz Eylül University, Medical School, Izmir, Turkey. osman.karakus@deu.edu.tr.|Çocuk Cerrahisi Anabilim Dalı, Tıp Fakültesi, Dokuz Eylül Üniversitesi, 35340, Balçova, Izmir, Turkey. osman.karakus@deu.edu.tr.
authors.forename: Osman Z
authors.identifier: http://orcid.org/0000-0002-5083-3647
authors.initials: OZ
authors.lastname: Karakuş
authors.affiliation: Department of Pediatric Surgery, Dokuz Eylül University, Medical School, Izmir, Turkey.
authors.forename: Oktay
authors.initials: O
authors.lastname: Ulusoy
authors.affiliation: Department of Pathology, Dokuz Eylül University, Medical School, Izmir, Turkey.
authors.forename: Güray
authors.initials: G
authors.lastname: Aktürk
authors.affiliation: Department of Pediatric Surgery, Dokuz Eylül University, Medical School, Izmir, Turkey.
authors.forename: Oğuz
authors.initials: O
authors.lastname: Ateş
authors.affiliation: Department of Morgue, Regional Center, Forensic Medicine Institutions, Izmir, Turkey.
authors.forename: Esra G
authors.initials: EG
authors.lastname: Olgun
authors.affiliation: Department of Morgue, Regional Center, Forensic Medicine Institutions, Izmir, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Dalgıç
authors.affiliation: Department of Pediatric Surgery, Dokuz Eylül University, Medical School, Izmir, Turkey.
authors.forename: Gülce
authors.initials: G
authors.lastname: Hakgüder
authors.affiliation: Department of Pathology, Dokuz Eylül University, Medical School, Izmir, Turkey.
authors.forename: Erdener
authors.initials: E
authors.lastname: Özer
authors.affiliation: Department of Pediatric Surgery, Dokuz Eylül University, Medical School, Izmir, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Olguner
authors.affiliation: Department of Pediatric Surgery, Dokuz Eylül University, Medical School, Izmir, Turkey.
authors.forename: Feza M
authors.initials: FM
authors.lastname: Akgür
mesh_terms: D000293:Adolescent; D016022:Case-Control Studies; D002452:Cell Count; D002648:Child; D002675:Child, Preschool; D002763:Cholecystectomy; D015529:Choledochal Cyst / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D002769:Cholelithiasis / Q000601:surgery; D003135:Common Bile Duct / Q000166:cytology* / Q000378:metabolism; D005260:Female; D005704:Gallbladder / Q000166:cytology* / Q000378:metabolism; D006801:Humans; D007150:Immunohistochemistry; D007223:Infant; D056885:Interstitial Cells of Cajal / Q000166:cytology* / Q000378:metabolism; D008297:Male; D019009:Proto-Oncogene Proteins c-kit / Q000378:metabolism
chemical_list: D019009:Proto-Oncogene Proteins c-kit
keywords: Choledochal cysts; Common bile duct; Extrahepatic biliary system; Gallbladder; Interstitial cells of Cajal