DOCSLIB.ORG

Human Peyer's Patches: an Immunohistochemical Study

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Human Peyer's Patches: an Immunohistochemical Study Gut: first published as 10.1136/gut.27.4.405 on 1 April 1986. Downloaded from Gut, 1986, 27, 405-410 Human Peyer's patches: an immunohistochemical study JO SPENCER, TERESA FINN, AND P G ISAACSON From the Department ofHistopathology, University College London School ofMedicine, London SUMMARY We have used immunoperoxidase techniques to characterise the Peyer's patches in human terminal ileum. The mantle zones of the B cell follicles in human Peyer's patches were surrounded by B cells which did not express surface IgD but which mostly expressed surface immunoglobulin of the IgM and/or IgAl isotype. Few cells expressing surface IgG or IgA2 were detected. Cells with cytoplasmic immunoglobulin of all isotypes except IgD were present in the dome regions of the Peyer's patches as well as in the lamina propria. There was little evidence of traffic of immunoglobulin synthesising cells across the high endothelial venules. T cells were seen to surround the lymphoid follicles. They were most concentrated on the serosal aspect around the high endothelial venules. Cells with macrophage-like morphology were present in both the lamina propria and the dome region of the follicles; those in the lamina propria containing lysozyme and those in the dome region S100 protein. The results are discussed in relation to the generation and dissemination of antibody producing cells in human gut. http://gut.bmj.com/ A wealth of information is available which defines rats, however, are found in approximately 10 clusters the processes involved in the activation, maturation along the length of the ileum and in sheep they are and migration of B cells resulting from immuno- densely concentrated in the terminal ileum.7 In logical stimulation of the guts of laboratory animals. these species the Peyer's patches are clearly visible Some of the B cells activated in the Peyer's patches macroscopically on the serosal surface of the bowel. migrate to the mesenteric lymph nodes where they Secondly the synthesis of IgA in human tissue is not mature into antibody producing cells.' These cells restricted to the mucosae to the extent seen in rats. on September 23, 2021 by guest. Protected copyright. then enter the blood through the thoracic duct and Unlike rats which synthesise mostly dimeric IgA, localise in the lamina propria of the gut where they man synthesises both monomeric and dimeric forms become plasma cells secreting antibody predomi- of two subclasses of IgA, the monomeric form not nantly of the IgA isotype.23 Sminia and Plesch4 apparently being involved in the protection of have supported these observations in rats using mucosal surfaces because of its inability to combine immunohistochemistry. with secretory component. Because of these dif- It is tempting to apply these theories on the ferences between the gut associated lymphoid tissue development of antibody producing cells in the gut of laboratory animals and man we have made an directly to human tissue, but there are differences immunohistochemical study of the Peyer's patches between the gut associated lymphoid tissue of man in human ileum the priority being to look for and laboratory animals even on a fundamental level. evidence of the maturation sites of antibody syn- First, the Peyer's patches themselves are distributed thesising cells generated in the Peyer's patches and differently. Peyer's patches in untreated human the migratory route of these B-cells to the lamina tissue are macroscopically invisible and they are propria. distributed in small clusters throughout the gastro- intestinal tract, being most concentrated in the Methods terminal ileum.5 The Peyer's patches of mice and TISSUE COLLECTION AND PROCESSING Address for correspondence: Dr J M Spencer, Department of Histopathology, University College London School of Medicine, University Street, London, Terminal ileum was collected from seven right WCIE 6JJ. hemicolectomy specimens resected at laparotomy Received for publication 21 June 1985. for adenoma or carcinoma of the colon. The patients 405 Gut: first published as 10.1136/gut.27.4.405 on 1 April 1986. Downloaded from 406 Spentcer, Finnt1, ands1 Isaacson were four women and three men ranging in age from centroblasts with euchromatic nuclei and medium 17-91 years. Specimens of macroscopically normal sized centrocytes with irregularly shaped hetero- ileum were fixed in 10% formalin containing 2% chromatic nuclei. The follicle centre was surrounded acetic acid8 and routinely processed and embedded by a mantle with indistinct borders composed of for paraffin sections. Tissue was also snap frozen in small lymphocytes which merged into a mixed liquid nitrogen for frozen sections. Sections of population of cells in the dome region of the follicle. terminal ileum were stained using haematoxylin and In addition to some small lymphocytes, the dome eosin. Blocks that contained Peyer's patch follicles region contained plasma cells, macrophages were selected for immunohistochemistry. IMMUNOHISTOCHEMISTRY The sources and the specificities of the antibodies used throughout this study are shown in the Table. Paraffin sections for immunostaining were de- waxed, rehydrated, and subjected to controlled trypsin digestion for optimal staining.'" Frozen sections were air dried for half an hour and fixed in fresh acetone for half an hour immediately before staining. With the polyclonal primary antibodies a peroxi- dase anti-peroxidase technique was used, and the monoclonal primary antibodies were used with a peroxidase conjugated secondary antibody. Peroxi- dase activity was shown using the 3,3-diamino- benzidine reagent. 12 The precise details of the techniques have been published elsewhere.'3 Results http://gut.bmj.com/ MORPHOLOGICAL OBSERVATIONS The most prominent feature of Peyer's patch follicles was the follicle centre which contained large Table Antibodies used in this study on September 23, 2021 by guest. Protected copyright. Monoclonal antibodies Source Specificity IgD Coultcr Clonc b-chains IgM Coultcr Clonc -chains IgA I Scward Laboratorics al -chains IgA2 Scward Laboratorics u2-chains T1 T ccils T4 Supprcssor T ccils Lcu3a Bcckton Dickinson Hclper ccils Nal/34 Scra Lab Langcrhans ccils, intcrdigitating ccils and cortical thymocytes KB6I (9) t B cclls othcr than folliclc centrc ccils b AN J'V V J2A IB5 (1(0) IILA-D rcgion antigen Fig. 1 Paraffin section of Peyer's patch Jfrom terminal Potlytlonatll antiAsera ileum. (a) Thefollicle centre is surrounded by a mantle IgG Dakopatts y-chain oJ Lysozymc Dakopatts Lysozymc small lymphocytes which has indistinct borders. The mamitle SII)() Dakopatts Cow 511(f brain protcin zone merges with a population ofcells ofintermnediate size and irregular nuclear outlines. These cells are illustrated in Antiscra wcrc kindly provided by *Drs P Bevcrlcy and. (b) where they extendfrom the dome region ofthefollicle tDr T Adams of the Impcrial Canccr Rcscirch Fund. London, into the overlying epithelium. Haematoxylin anid eosin, tDr K Pulford of the John Raidcliffc Hospital. Oxford. (a) x 125, (b) x280, orig mag. Gut: first published as 10.1136/gut.27.4.405 on 1 April 1986. Downloaded from Human Peyer's patches: an immunohistochemical study 4(J7 * k c .j http://gut.bmj.com/ Fig. 2 Serialfrozen sections ofa Peyer's patch immunostained using (a) the monoclonal antibody KB6J which recognises an antigen on B cells other than follicle centre B cells, (b) anti-IgD, (c) anti-IgAI, (d) anti-IgM. B cells recognised by KB61 are present in excess ofthe mantle cells which express surface IgD. Most ofthe B cells which surround the mantle zone appear to express slgM andlor sIgAl. Immunoperoxidase (x 100, orig. mag). and cells with irregularly shaped heterochromatic region and between the dome epithelial cells and nuclei similar to the centrocytes in the follicle centre into the T cell zone (Fig. 2 b,c,d). Cells with sIgA2 on September 23, 2021 by guest. Protected copyright. (Fig. 1). These cells were also present infiltrating and sIgG could be seen occasionally in the Peyer's between the epithelial cells of the dome, but not the patches. epithelium of the adjacent crypts. They were also The follicle centres contained network staining of continuous with the zone of cells on the serosal immunoglobulin of all isotypes except IgD. This aspect of the follicle which contained the high immunoglobulin bound to the follicular dendritic endothelial venules. reticulum cells masked any positivity which may have been present on the follicle centre cells IMMUNOHISTOCHEMICAL OBSERVATIONS themselves. Frozen sections Helper and suppressor T-cells were present in the Cells with surface immunoglobulin (sIg) were stu- T-cell zones extending around the follicles and into died in cryostat sections of Peyer's patches. Clear the mixed cell zones, the ratio of helpers to rings of immunostaining were seen around the suppressors being approximately 7:1 but this varied outside of cells with slg rather than the thicker more between individuals. T helper cells were observed in diffuse rings of staining which surrounded the nuclei the follicle centres. of cells with cytoplasmic immunoglobulin (clg). The antibody Nal/34 recognised only occasional The mantle zone was composed of cells with cells between the follicles in Peyer's patches. No sIgD and sIgM but this was diminuitive when com- cells were stained in the dome regions. pared with the total number of B cells present in the Peyer's patches outside the follicle centre Paraffin sections (Fig. 2 a,b). Cells with sIgM and sIgAl surrounded Most of the cells with clg were observed in the dome the mantle zone extending both into the dome regions of the Peyer's patches and the adjacent Gut: first published as 10.1136/gut.27.4.405 on 1 April 1986. Downloaded from 408 Spencer, Finn, and Isaacson lamina propria, although some cells with cIg could frequency of cells with cIgG appeared to decrease occasionally be seen within the follicle centres. It with increasing distance from the follicle.
Load more

Recommended publications
  • Submucosa Precedes Lamina Propria in Initiating Fibrosis in Oral Submucous Fibrosis - Evidence Based on Collagen Histochemistry
    SUBMUCOSA PRECEDES LAMINA PROPRIA IN INITIATING FIBROSIS IN ORAL SUBMUCOUS FIBROSIS - EVIDENCE BASED ON COLLAGEN HISTOCHEMISTRY. *Anna P. Joseph ** R. Rajendran Abstract Oral submucous fibrosis is a chronic insidious disease and a well-recognized potentially malignant condition of the oral cavity. It is a collagen related disorder associated with betel quid chewing and characterized by progressive hyalinization of the lamina propria. Objectives: It is traditionally held that in oral submucous fibrosis the hyalinization process starts from the lamina propria and progresses to involve the submucosal tissues. However reports of some investigators suggest that on the contrary, the fibrosis starts in the submucosa and not in the juxta epithelium as previously assumed. Methods: A histochemical study comparing the pattern of collagen deposition and hyalinization in early and advanced cases of oral submucous fibrosis was done using special stain for collagen. Result & Conclusion: The results suggest that in a certain percentage of cases submucosa precedes the lamina propria in initiating fibrosis in this disease. This could have implications on the differences in clinical presentation, biological progression, neoplastic transformation and responsiveness to treatment. Introduction fibrosis (OSF) is an insidious chronic fibrotic disease and a well recognized premalignant Fibrosis, a conspicuous feature of condition that involves the oral mucosa and chronically inflamed tissue is characterized by occasionally the pharynx and the upper progressive
    [Show full text]
  • Normal Gross and Histologic Features of the Gastrointestinal Tract
    NORMAL GROSS AND HISTOLOGIC 1 FEATURES OF THE GASTROINTESTINAL TRACT THE NORMAL ESOPHAGUS left gastric, left phrenic, and left hepatic accessory arteries. Veins in the proximal and mid esopha- Anatomy gus drain into the systemic circulation, whereas Gross Anatomy. The adult esophagus is a the short gastric and left gastric veins of the muscular tube measuring approximately 25 cm portal system drain the distal esophagus. Linear and extending from the lower border of the cri- arrays of large caliber veins are unique to the distal coid cartilage to the gastroesophageal junction. esophagus and can be a helpful clue to the site of It lies posterior to the trachea and left atrium a biopsy when extensive cardiac-type mucosa is in the mediastinum but deviates slightly to the present near the gastroesophageal junction (4). left before descending to the diaphragm, where Lymphatic vessels are present in all layers of the it traverses the hiatus and enters the abdomen. esophagus. They drain to paratracheal and deep The subdiaphragmatic esophagus lies against cervical lymph nodes in the cervical esophagus, the posterior surface of the left hepatic lobe (1). bronchial and posterior mediastinal lymph nodes The International Classification of Diseases in the thoracic esophagus, and left gastric lymph and the American Joint Commission on Cancer nodes in the abdominal esophagus. divide the esophagus into upper, middle, and lower thirds, whereas endoscopists measure distance to points in the esophagus relative to the incisors (2). The esophagus begins 15 cm from the incisors and extends 40 cm from the incisors in the average adult (3). The upper and lower esophageal sphincters represent areas of increased resting tone but lack anatomic landmarks; they are located 15 to 18 cm from the incisors and slightly proximal to the gastroesophageal junction, respectively.
    [Show full text]
  • Anatomy, Histology, and Embryology
    ANATOMY, HISTOLOGY, 1 AND EMBRYOLOGY An understanding of the anatomic divisions composed of the vomer. This bone extends from of the head and neck, as well as their associ- the region of the sphenoid sinus posteriorly and ated normal histologic features, is of consider- superiorly, to the anterior edge of the hard pal- able importance when approaching head and ate. Superior to the vomer, the septum is formed neck pathology. The large number of disease by the perpendicular plate of the ethmoid processes that involve the head and neck area bone. The most anterior portion of the septum is a reflection of the many specialized tissues is septal cartilage, which articulates with both that are present and at risk for specific diseases. the vomer and the ethmoidal plate. Many neoplasms show a sharp predilection for The supporting structure of the lateral border this specific anatomic location, almost never of the nasal cavity is complex. Portions of the occurring elsewhere. An understanding of the nasal, ethmoid, and sphenoid bones contrib- location of normal olfactory mucosa allows ute to its formation. The lateral nasal wall is visualization of the sites of olfactory neuro- distinguished from the smooth surface of the blastoma; the boundaries of the nasopharynx nasal septum by its “scroll-shaped” superior, and its distinction from the nasal cavity mark middle, and inferior turbinates. The small su- the interface of endodermally and ectodermally perior turbinate and larger middle turbinate are derived tissues, a critical watershed in neoplasm distribution. Angiofibromas and so-called lym- phoepitheliomas, for example, almost exclu- sively arise on the nasopharyngeal side of this line, whereas schneiderian papillomas, lobular capillary hemangiomas, and sinonasal intesti- nal-type adenocarcinomas almost entirely arise anterior to the line, in the nasal cavity.
    [Show full text]
  • Ultrastructure of Endocrine-Like Cells in Lamina Propria of Human Gastric Mucosa
    Gut: first published as 10.1136/gut.22.7.534 on 1 July 1981. Downloaded from Gut, 1981, 22, 534-541 Ultrastructure of endocrine-like cells in lamina propria of human gastric mucosa* J STACHURA, W J KRAUSE, AND K J IVEYt From the Veterans Administration Medical Center, Long Beach, California; University of California Irvine, Irvine, California; Department of Anatomy, University of Missouri School of Medicine, Columbia, Missouri; and the Institute ofPathology, Copernicus Medical Academy, Krakow, Polantd SUMMARY Endocrine cells of gastric and gut mucosa are commonly thought to be present only within mucosal glands. In a previous report, we described argyrophilic cells in the lamina propria in 40 % of surgical gastric specimens, using light microscopy. All these patients had chronic gastritis. Argyrophilia, however, is a non-specific reaction which could occur in other than endocrine cells. The present study was undertaken to describe the ultrastructure of argyrophil cells in the lamina propria. In five patients with chronic gastritis, endoscopic biopsies were taken from the fundic, intermediate, and pyloric areas of the stomach. Single and/or clustered argyophil cells were seen by light microscopy in the lamina propria of the intermediate and pyloric are.as. On electron- microscopy, these cells had the following characteristics of endocrine-like cells: they were characterised by numerous electron dense granules in the cytoplasm, 100-300 nm in diameter; the cytoplasm contained poorly-developed rough endoplasmic reticulum and well-developed smooth endoplasmic reticulum with occasional vesicles. Immunostaining gave negative results for various gastrointestinal hormones. These ultrastructural characteristics of lamina propria cells are similar to endocrine cells of the APUD series.
    [Show full text]
  • The Gallbladder
    The Gallbladder Anatomy of the gallbladder Location: Right cranial abdominal quadrant. In the gallbladder fossa of the liver. o Between the quadrate and right medial liver lobes. Macroscopic: Pear-shaped organ Fundus, body and neck. o Neck attaches, via a short cystic duct, to the common bile duct. Opens into the duodenum via sphincter of Oddi at the major duodenal papilla. Found on the mesenteric margin of orad duodenum. o 3-6 cm aboral to pylorus. 1-2cm of distal common bile duct runs intramural. Species differences: Dogs: o Common bile duct enters at major duodenal papilla. Adjacent to pancreatic duct (no confluence prior to entrance). o Accessory pancreatic duct enters at minor duodenal papilla. ± 2 cm aboral to major duodenal papilla. MAJOR conduit for pancreatic secretions. Cats: o Common bile duct and pancreatic duct converge before opening at major duodenal papilla. Thus, any surgical procedure that affects the major duodenal papilla can affect the exocrine pancreatic secretions in cats. o Accessory pancreatic duct only seen in 20% of cats. 1 Gallbladder wall: 5 histologically distinct layers. From innermost these include: o Epithelium, o Submucosa (consisting of the lamina propria and tunica submucosa), o Tunica muscularis externa, o Tunica serosa (outermost layer covers gallbladder facing away from the liver), o Tunica adventitia (outermost layer covers gallbladder facing towards the liver). Blood supply: Solely by the cystic artery (derived from the left branch of the hepatic artery). o Susceptible to ischaemic necrosis should its vascular supply become compromised. Function: Storage reservoir for bile o Concentrated (up to 10-fold), acidified (through epithelial acid secretions) and modified (by the addition of mucin and immunoglobulins) before being released into the gastrointestinal tract at the major duodenal.
    [Show full text]
  • Correlation of Ultrasonographic Small Intestinal Wall Layering with Histology in Normal Dogs
    Louisiana State University LSU Digital Commons LSU Master's Theses Graduate School 2015 Correlation of Ultrasonographic Small Intestinal Wall Layering with Histology in Normal Dogs Alexandre Benjamin Le Roux Louisiana State University and Agricultural and Mechanical College, [email protected] Follow this and additional works at: https://digitalcommons.lsu.edu/gradschool_theses Part of the Veterinary Medicine Commons Recommended Citation Le Roux, Alexandre Benjamin, "Correlation of Ultrasonographic Small Intestinal Wall Layering with Histology in Normal Dogs" (2015). LSU Master's Theses. 1148. https://digitalcommons.lsu.edu/gradschool_theses/1148 This Thesis is brought to you for free and open access by the Graduate School at LSU Digital Commons. It has been accepted for inclusion in LSU Master's Theses by an authorized graduate school editor of LSU Digital Commons. For more information, please contact [email protected]. CORRELATION OF ULTRASONOGRAPHIC SMALL INTESTINAL WALL LAYERING WITH HISTOLOGY IN NORMAL DOGS A Thesis Submitted to the Graduate Faculty of the Louisiana State University and Agricultural and Mechanical College in partial fulfillment of the requirements for the degree of Masters of Science in The School of Veterinary Medicine through The Department of Veterinary Clinical Sciences by Alexandre Benjamin Le Roux DrMedVet, Ecole Nationale Vétérinaire de Nantes, 2006 May 2015 To my parents, my family and all my friends, for their continuous support… ii ACKNOWLEDGMENTS Foremost, I would like to express my deepest gratitude to the members of my committee, Drs. Lorrie Gaschen, Frederic Gaschen, Abbigail Granger and Nathalie Rademacher for the continuous support and guidance that they gave me through my residency and Master program research, as well as during the preparation of this manuscript.
    [Show full text]
  • Terminology: Nomenclature of Mucosa-Associated Lymphoid Tissue
    nature publishing group ARTICLES See COMMENTARY page 8 See REVIEW page 11 Terminology: nomenclature of mucosa-associated lymphoid tissue P B r a n d t z a e g 1 , H K i y o n o 2 , R P a b s t 3 a n d M W R u s s e l l 4 Stimulation of mucosal immunity has great potential in vaccinology and immunotherapy. However, the mucosal immune system is more complex than the systemic counterpart, both in terms of anatomy (inductive and effector tissues) and effectors (cells and molecules). Therefore, immunologists entering this field need a precise terminology as a crucial means of communication. Abbreviations for mucosal immune-function molecules related to the secretory immunoglobulin A system were defined by the Society for Mucosal Immunolgy Nomenclature Committee in 1997, and are briefly recapitulated in this article. In addition, we recommend and justify standard nomenclature and abbreviations for discrete mucosal immune-cell compartments, belonging to, and beyond, mucosa-associated lymphoid tissue. INTRODUCTION for dimers (and larger polymers) of IgA and pentamers of It is instructive to categorize various tissue compartments IgM was proposed in 1974. 3,4 The epithelial glycoprotein involved in mucosal immunity according to their main function. designated secretory component (SC) by WHO in 1972 However, until recently, there was no consensus in the scientific (previously called “ transport piece ” or “ secretory piece ” ) turned community as to how these compartments should be named and out to be responsible for the receptor-mediated transcytosis classified. This lack of standardized terminology has been particu- of J-chain-containing Ig polymers (pIgs) through secretory larly confusing for newcomers to the mucosal immunology field.
    [Show full text]
  • Cells Intestinal Lamina Propria As Regulatory T Cells in Human Bright CD25 +CD4
    The Journal of Immunology CD4؉CD25bright T Cells in Human Intestinal Lamina Propria as Regulatory Cells1 Shin Makita,* Takanori Kanai,2* Shigeru Oshima,* Koji Uraushihara,* Teruji Totsuka,* Taisuke Sawada,* Tetsuya Nakamura,* Kazutaka Koganei,† Tsuneo Fukushima,† and Mamoru Watanabe* It is well known that immune responses in the intestine remain in a state of controlled inflammation, suggesting that not only active suppression by regulatory T cells plays an important role in the normal intestinal homeostasis, but also its dysregulation leads to the development of inflammatory bowel disease. In this study, we demonstrate that the CD4؉CD25bright T cells reside in the human intestinal lamina propria (LP) and functionally retain regulatory activities. All human LP CD4؉ T cells regardless of CD25 expression constitutively expressed CTLA-4, glucocorticoid-induced TNFR family-related protein, and Foxp3 and proliferate poorly. Although LP CD4؉CD25؊ T cells showed an activated and anergic/memory phenotype, they did not retain regulatory activity. In LP CD4؉CD25؉ T cells, however, cells expressing CD25 at high levels (CD4؉CD25bright) suppressed the proliferation and various cytokine productions of CD4؉CD25؊ T cells. LP CD4؉CD25bright T cells by themselves produced fewer amounts of IL-2, IFN-␥, and IL-10. Interestingly, LP CD4؉CD25bright T cells with regulatory T activity were significantly increased in patients with active inflammatory bowel disease. These results suggest that CD4؉CD25bright T cells found in the normal and inflamed intestinal mucosa selectively inhibit the host immune response and therefore may contribute to the intestinal immune homeostasis. The Journal of Immunology, 2004, 173: 3119–3130. he gastrointestinal tract is home to the largest number of of an intact immune system for the intestinal homeostasis is re- leukocytes in the body as well as being the site where vealed by the fact that a number of immune manipulations, includ- these cells encounter abundant exogenous stimuli.
    [Show full text]
  • 46 Small Intestine
    Small Intestine The small intestine extends between the stomach and colon and is divided into the duodenum, jejunum, and ileum. Although there are minor microscopic differences among these subdivisions, all have the same basic organization as the rest of the digestive tube - mucosa, submucosa, muscularis externa, and serosa or adventitia. The transition from one segment to another is gradual. The proximal 12 inches of its length is generally considered duodenum, the remaining proximal two-fifths jejunum and the distal three-fifths ileum. The small intestine moves chyme from the stomach to the colon and completes the digestive processes by adding enzymes secreted by the intestinal mucosa and accessory glands (liver and pancreas). Its primary function, however, is absorption. Approximately 8 to 9 liters of fluid enters the small intestine on a daily basis. Food and liquid intake represents 1-2 liters of this volume the remainder coming from endogenous sources such as salivary, gastric, intestinal, pancreatic, and biliary secretions. Of this volume 6-7 liters is absorbed in the small intestine with only 1-2 liters entering the colon the majority of which is absorbed at this location. Only as very small amount of fluid is evacuated in the stool. The majority of water is absorbed passively in the gut and is largely dependent on an osmotic gradient. Specializations for Absorption Three specializations - plicae circulares, intestinal villi, and microvilli - markedly increase the surface area of the intestinal mucosa to enhance the absorptive process. It is estimated that these morphological features provide an absorptive surface area of 200 M2. Plicae circulares are large, permanent folds that consist of the intestinal mucosa and a core of submucosa.
    [Show full text]
  • The Microscopic Anatomy of the Esophagus Including the Individual Layers Specialized Tissues and Unique Components, and Their Responses to Injury
    The microscopic anatomy of the esophagus including the individual layers specialized tissues and unique components, and their responses to injury Xuchen Zhang,1 Deepa Patil,2 Robert D. Odze,3 Lei Zhao, 3 Mikhail Lisovsky,4 Maha Guindi,5 Robert Riddell,6 Andrew Bellizzi,7 Rhonda K Yantiss,8 Ilke Nalbantoglu,1 Henry D. Appelman,9 1Yale University, New Haven, CT, 2Cleveland Clinic, Cleveland, OH, 3Brigham and Women’s Hospital and Harvard University, Boston, MA, 4Dartmouth University, Lebanon, NH, 5Cedars-Sinai Hospital, Los Angeles, CA, 6Mt Sinai Hospital and University of Toronto, Toronto, Ontario, 7University of Iowa, Iowa City, IA, 8Weill Cornell Medicine, New York, NY, 9University of Michigan, Ann Arbor, MI Address for correspondence: Henry D. Appelman, MD, Department of Pathology, University of Michigan, Ann Arbor, Michigan. [email protected] Short title: Microscopic anatomy of esophagus Abstract The esophagus, a straight tube that connects the pharynx to the stomach, has the complex architecture common to the rest of the gastrointestinal tract with special differences that relate to its function as a conduit of ingested substances. For instance, it has submucosal glands that are unique that have a specific protective function. It has a squamous lining that exists nowhere else in the gut except the anus and it has a different submucosal nerve plexus when compared to the stomach and This is the author manuscript accepted for publication and has undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as doi: 10.1111/nyas.13705.
    [Show full text]
  • Stomach Tumors Benign Tumors Fundic Gland Polyps Benign
    Last updated: 6/11/2020 Prepared by Kurt Schaberg Stomach Tumors Benign Tumors Fundic Gland Polyps Benign. Most common stomach polyp. Hyperplastic expansion of deep oxyntic mucosa with cystically dilated oxyntic glands and foveolar hypoplasia. Parietal cell hyperplasia Usually asymptomatic and incidental. Associated with PPI use Can have CTNNB1 (β-catenin) mutations If numerous (esp. >20) in a young patient, consider a polyposis syndrome, such as FAP. Hyperplastic Polyps Benign. Second most common gastric polyp Elongated, tortuous, hyperplastic foveolar epithelium Cystically dilated glands Inflammatory changes and edema Often eroded at surface. Small, haphazardly distributed smooth muscle Hyperproliferative response to tissue injury. Usually arise in setting of long-standing gastritis Precursor lesion = polypoid foveolar hyperplasia May be hard to differentiate from hamartomatous polyps (e.g., Cronkhite-Canada syndrome) Pyloric Gland adenoma Polypoid proliferation of pyloric-type gastric glands (cuboidal to columnar cells with foamy, ground- glass cytoplasm) and no well-formed apical mucin cap. Often dilated glands. Basal round nuclei. Usually older individuals with atrophic/metaplastic autoimmune gastritis and/or H. pylori Sometimes syndromic (e.g., FAP, GAPPs, etc…) Activating GNAS and/or KRAS mutations and inactivating APC mutations. Can develop high-grade dysplasia → carcinoma Stain with MUC6 Dysplasia Low-grade foveolar-type dysplasia Neoplastic change of gastric epithelium without stromal invasion. Can be gastric/foveolar or intestinal-type (or mixed): Intestinal-type dysplasia: looks like a colonic adenoma with tall columnar cells with hyperchromatic nuclei Gastric/Foveolar-type dysplasia has tubulovillous or serrated fronds lined by cuboidal to columnar cells resembling gastric foveolar cells. Nuclei are round to oval. There is apical neutral mucin.
    [Show full text]
  • Lips* Cheeks* Hard / Soft Palate Uvula
    DIGESTIVE ANATOMY REVIEW GUIDE GROSS ANATOMY Oral Cavity* (Figure / Cadaver* ) Teeth (Figure) Lips* Incisors / Canines / Premolars / Molars Cheeks* Crown Hard / Soft palate Enamel Uvula Gingiva Tongue Root Palatoglossal arches Cementum Palatopharyngeal arches Periodontal ligaments Lingual frenulum Dentin Pulp cavity Esophagus (Model) Root canal Cardiac sphincter Salivary Glands* (Figure / Cadaver*) Stomach* (Figure / Model / Cadaver*) Parotid glands* Greater / Lesser curvatures* Parotid duct Greater / Lesser omentum Submandibular glands* Cardia* / Fundus* / Body* / Pylorus* Submandibular duct Rugae Sublingual glands Pyloric sphincter* Liver* (Figure / Model / Cadaver*) Small Intestine* (Figure / Model / Cadaver*) Right / Left / Caudate / Quadrate lobes* Duodenum* / Jejunum / Ileum* Falciform ligament* Mesentery* Common hepatic duct Ileocecal valve* Common bile duct* Circular folds Hepatopancreatic ampulla Large Intestine* (Figure / Model / Cadaver*) Duodenal papilla Cecum* Gallbladder* (Model / Figure / Cadaver*) Appendix Cystic duct* Ascending / Transverse colon* Descending / Sigmoid colon* Pancreas* (Figure / Model / Cadaver*) Teniae coli* Pancreatic duct Haustra* Mesocolon Rectum External / Internal anal sphincter BI 335 – Advanced Human Anatomy and Physiology Western Oregon University DIGESTIVE ANATOMY REVIEW GUIDE HISTOLOGY Alimentary Canal (Histological image / slide) Small Intestine (Histological image / slide) Mucosa Mucosa Epithelium Simple columnar epithelium Lamina propria
    [Show full text]