Journal of Neurogastroenterology and Motility : eISSN 2093-0887 / pISSN 2093-0879

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Fig. 2. Pathologic characteristics of typical hypoganglionosis with transition zone (TZ) (patient No. 13). (A) Gross photograph shows markedly dilated proximal colonic segments, non-dilated distal segments, and TZ connecting them (arrow). Dashed line indicates hypoganglionic segment. (B) Myenteric plexus of the proximal dilated segment shows abundant ganglion cells and Schwann cells (×40 objective lens, scale bar = 50 μm). (C) Myenteric plexus in TZ shows atrophic Schwann cells without ganglion cells or inflammation (×40 objective lens, scale = 50 μm). (D) Schematic view of a novel pathologic analysis. In this particular case, sections were taken every 5-cm (intervals of vertical lines of upper panel). Numbers of ganglion cells are markedly decreased especially in the distal TZ and the decrease in ganglion cells is observed for a certain length (approximately 10 cm in this case) after TZ. Then, the number of ganglion cells recovers thereafter. The recovered ganglion cell numbers are seemingly larger than those of proximal dilated segment, but both become similar when the internal circumference (IC) is taken into account (lower panel).
Journal of Neurogastroenterology and Motility 2019;25:137~147 https://doi.org/10.5056/jnm18121
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