Obliteration of the processus vaginalis during the fetal growth begins with a transient decrease in sympathetic tonus and then ends with smooth muscle cells (SMCs) undergoing apoptosis. Otherwise, an inguinal hernia (IH) occurs due to the defective obliteration. Although the mechanism in the formation of an inguinal hernia has been elucidated by many investigations, it has not been investigated whether proliferation in the IH sac cells which would lead to the benign or malignant process. In this study, we aimed to examine whether the proliferative changes in the cells of IH sac would be a histopathological precursor to any process.
We obtained fifty (male 25, female 25) samples of the IH sac from patients (study group) during operations. Control groups were formed from twelve parietal peritoneum samples (male 4, female 8) undergoing laparotomy for various reasons, and two processus vaginalis samples obtaining from 2 boys. Samples were evaluated regarding mesothelial, smooth muscle, neuronal, adipose, and vascular tissue proliferation as well as inflammation and congestion. Histopathological evaluation was made with H&E staining. Immunohistochemical evaluation was performed with PCNA and HBME-1 known the proliferative and the mesothelial marker, respectively.
There were significantly increased mesothelial, vascular, nerve, and SMC proliferation in the study groups compared with those of control groups (p < 0.05). The expression of HBME-1 and PCNA was significantly increased (p < 0.05) in control groups compared with those of controls.
We determined that the proliferation of SMCs increased in the IH sac as in previous studies. We also found the increased proliferation in the mesothelial cells together with the increased HBME-1 and PCNA expressions in the IH sac. These alterations may be an initiator of a benign or malignant process by which would be able to develop in the IH sac.