The topography and phenotype of mast cells in the human area postrema, together with correlation between mast-cell density and microvessel density (MVD), were analysed in 16 brains. Transverse serial sections of formalin-fixed, paraffin-embedded brainstems were stained with toluidine blue and alcian blue/safranin stainings, and with anti-tryptase and anti-CD31 monoclonal antibodies. The mean (+/- SD) numbers of mast cells per section were 1.3 +/- 0.8 and 1.2 +/- 0.7 with toluidine blue and alcian blue/safranin, respectively, whereas anti-tryptase monoclonal antibody showed a mean of 5.1 +/- 2.4 cells. Mast cells were alcian blue- and safranin-positive in 56%, because of the coexistence of low-sulphated (blue-staining) and high-sulphated (red-staining) granules. No significant linear correlation between mast-cell density (4.9 mm(-2)) and MVD (114.5 mm(-2)) was found (r(2) = 0.19, P = 0.09). Mast cells were frequently located close to blood vessels (55%) (33% to venules, 22% to arterioles), indicating that their products play a role in the regulation of blood flow and in vessel permeability in the area postrema. Mast cells were located subependymally in 44% and close to the dorsal aspect of the nucleus of the tractus solitarius in 31%, suggesting a subregional distribution.