Colon nontumor
General
Normal histology




Topic Completed: 1 May 2013

Revised: 7 January 2019, last major update May 2013

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PubMed Search: Colon nontumor histology

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Cite this page: Gulwani H. Normal histology. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/colonhistology.html. Accessed April 23rd, 2019.
Definition / general
  • Composed of mucosa, submucosa, muscularis propria (externa) and serosa (perimuscular tissue in rectum)
  • Mucosa: epithelium, lamina propria and muscularis mucosa
  • Epithelium:
    • Low columnar to cuboidal cells
    • Tubules are tightly packed, have straight test tube shape (minimal branching), parallel to each other, straight luminal surface, rest on thin basement membrane, extend to muscularis mucosa; have absorptive cells and goblet cells
    • Crypts open into surface epithelium or into innominate grooves
    • Crypts are surrounded by pericryptal fibroblast sheath (fibroblasts or myofibroblasts, J Clin Pathol 1999;52:785)
    • Crypts also contain precursor cells, endocrine cells and Paneth cells in right sided colon
    • Intestinal crypt is a proliferative compartment, monoclonal, maintained by stem cells
    • Villus represents the differentiated compartment and is polyclonal as it receives cells from multiple crypts
    • Wnt signaling is important for cell proliferation, differentiation, apoptosis along the crypt-villus axis (Stem Cell Rev 2006;2:203, J Pathol 2002;197:492)
    • Paneth cells constitute the niche for Lgr5 stem cells in intestinal crypts (Transl Res 2010;156:180)
    • In colon crypts, CD24+ cells residing between Lgr5 stem cells may represent the Paneth cell equivalents (Nature 2011;469:415)
    • Colon cancer may emerge at niche of tissue stem cells (cancer stem cells) which are LGR5+, Nanong- (Acta Histochem 2013;115:320)
  • Positive stains: CDX2 (sensitive and specific for colon), CK8, CK18, CK19
  • Innominate grooves: mucosal area where several crypts open into one central crypt
  • Lamina propria:
    • Capillaries (uniform), lymphatics just above muscularis mucosa
    • Inflammatory cells present (see below)
  • Muscularis mucosa: thin and regular
  • Submucosa:
    • Loose connective tissue with submucosal plexus of Meissner
    • Minimal inflammatory infiltrate
    • Younger patients may have intramucosal lymphoid aggregates that disrupt muscularis mucosa
  • Muscularis propria: inner circular layer, myenteric plexus of Auerbach, outer longitudinal layer
  • Serosa: single layer of flat to low cuboidal mesothelial cells and adjacent fibroelastic tissue
Microscopic (histologic) images

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MSH6

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PMS2

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Mucosa and submucosa

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Crypts

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Submucosal plexus of Meissner


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Normal mucosa

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Rectum

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Rectal folds of Morgagni



Pericryptal fibroblast sheath:
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Figures c & d

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Sheath is positive for high molecular weight caldesmon

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Sheath is positive for alpha smooth muscle actin

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CDX2

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