What question did this study set out to answer?

This analysis aims to evaluate the effectiveness of CD117 immunohistochemistry versus special stains in identifying mast cells in lung tissues affected by asphyxia.

February 11, 2026

A Comparative Analysis of the Efficacy of CD117 and Special Stains as Indicators of Mechanical Asphyxial Deaths

Key Points

This analysis aims to evaluate the effectiveness of CD117 immunohistochemistry versus special stains in identifying mast cells in lung tissues affected by asphyxia.
Examined lung samples from 164 medicolegal autopsies, comprising 57 asphyxial and 107 non-asphyxial cases.
Analyzed peribronchial and perialveolar regions using CD117 IHC, Toluidine Blue, and Giemsa stains.
Compared mast cell counts using Mann–Whitney U and Kruskal-Wallis tests.
Mast cell counts were significantly higher in asphyxial cases compared to non-asphyxial cases.
IHC yielded a peribronchial count of 2.27 ± 1.02, while Giemsa only showed 0.84 ± 0.59.
IHC exhibited higher sensitivity than Giemsa (P < 0.001), and Toluidine Blue was comparable to IHC.

Abstract

Abstract Background: Determining the cause of death in suspected asphyxia is often difficult when external findings are absent. Mast cells (MCs) may provide objective histological evidence of hypoxia. Objective: To compare the efficacy of immunohistochemistry (IHC) using CD117 with Toluidine Blue (TB) and Giemsa (GM) stains in detecting mast cells in asphyxial and non-asphyxial lung tissues. Materials and Methods: Lung samples from 164 medicolegal autopsies at AIIMS Jodhpur were studied, 57 asphyxial and 107 non-asphyxial deaths. Peribronchial and perialveolar regions were examined using TB, GM, and IHC (CD117). Mean mast cell counts were compared using Mann–Whitney U and Kruskal-Wallis tests. Results: Mast cell counts were significantly higher in asphyxial cases. Peribronchial counts: IHC 2.27 ± 1.02, TB 2.29 ± 1.19, GM 0.84 ± 0.59. Perialveolar counts: IHC 0.74 ± 0.12, TB 0.10 ± 0.19, GM 0.01 ± 0.51. IHC was more sensitive than GM (P < 0.001), while TB showed comparable efficacy to IHC. Conclusion: CD117-based IHC is the most sensitive method for identifying mast cells in asphyxial lungs, though TB remains a valuable low-cost option. Mast cell analysis can serve as an adjunct marker in diagnosing mechanical asphyxia.

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