Pathomorphological Changes in Vater-Pacinian Corpuscles in Palmar Fascial Fibromatosis Depending on the Dupuytren’s Contracture Degree

Abstract

Summary. World literature data indicate the involvement of Vater-Pacini bodies in the pathogenesis of palmar fascial fibromatosis, but the information about their pathomorphological changes and histomorphometric characteristics is contradictory. Purpose. To make a comparative analysis of qualitative and quantitative changes in Vater-Pacini bodies in patients with Dupuytrens contracture of varying degrees. Materials and Methods. The analysis of case histories and material resected during operations from 100 patients with Dupuytren's contracture, was made. The patients were divided into two groups: group 1 those with degree I-II contracture (n=31), group 2 those with degree III-IV (n=69). Histomorphometry of 122 Vater-Pacini bodies, in which the cut plane passed through the central nucleus, was performed in paraffin and semi-thin sections of the patients surgical material. Results. At the time of the disease onset, the difference in age medians in the groups was not statistically significant (p=0.080). The age median at the time of surgery and the median of the disease duration were higher in group 2 (p=0.001; p=0.006, respectively), the variability in the disease duration was comparable. As it has been established, Vater-Pacini bodies undergo successive reactive-destructive changes in the form of death of the central axon, stratification of the capsule, inflammation, fibrosis, deformation and destruction. The number of bodies is greater in group 1 than in group 2 (p=0.040). In group 2, the bodies have larger diameters (p=0.072), more layers of the outer capsule (p=0.032) and lower values of the shape factor (p=0.015). Conclusion. In patients with Dupuytren's contracture, along with compensatory and adaptive changes in bodies (hyperplasia and hypertrophy), their irreversible destructive changes develop, which, when the disease progresses to grade 3-4, lead to a loss in the number of bodies.