Esophagus
General
Histology

Author: Elliot Weisenberg, M.D. (see Authors page)

Revised: 4 January 2018, last major update August 2012

Copyright: (c) 2003-2018, PathologyOutlines.com, Inc.

PubMed Search: Esophagus[TIAB] histology[TI]

Cite this page: Weisenberg, E. Histology. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/esophagusnormalhistology.html. Accessed February 20th, 2018.
Definition / general
  • Layers (similar to GI tract): mucosa, submucosa, muscularis propria and adventitia

  • Mucosa: epithelium, lamina propria and muscularis mucosae
    • Epithelium: nonkeratinized stratified squamous epithelium with melanocytes, endocrine cells, Langerhans cells, Merkel cells and T cells with convoluted nuclei ("squiggle cells"); basal zone has basophilic proliferative cells with minimal cytoplasm, usually 3 - 4 cells thick, 15% or less of epithelial thickness except distally; suprabasal zone (with prickle and functional [anucleated] cell layers) has glycogen rich squamous cells that flatten and mature as they approach lumen / surface
    • Lamina propria: fibrovascular connective tissue between epithelium and muscularis mucosae; folds into slender papillae that projects into epithelium, usually less than 2/3 of epithelial thickness; may contain gastric cardia-like mucus glands lined by foveolar-like cells with neutral mucin (PASD positive, Alcian blue at pH 2.5 negative), particularly in distal esophagus; also scattered inflammatory cells
    • Muscularis mucosae: smooth muscle bundles oriented longitudinally; begins at cricoid cartilage and becomes thickened distally, where it may resemble muscularis propria (important to remember for accurate AJCC staging of adenocarcinoma in this region)

  • Submucosa: loose connective tissue with vessels, lymphatics, occasional white blood cells, lymphoid follicles (rare), Meissner plexus (sparse ganglia) and nerves, submucosal glands lined by mucinous cells that produce acid mucin (continuation of minor salivary glands of oropharynx) that drain through cuboidal or squamous lined ducts; glands are PASD+, Alcian blue+ at pH 2.5 (indicates acidic mucin) and also produce bicarbonate; ducts are positive for CK7, CK8 / 18, CK14 and CK19
  • Muscularis propria: inner circular and outer longitudinal layers; proximally includes skeletal muscle from cricopharyngeus and inferior pharyngeal constrictor muscles (thus, skeletal muscle disorders cause esophageal dysfunction); contains Auerbach (myenteric) plexus
  • Note: longitudinal muscle originates as two bands from cricoid cartilage that incompletely digitate and leaves a bare V shaped region (area of Laimer) that exposes the underlying circular muscle and creates area of weakness where Zenker diverticulum (a pharyngeal diverticulum due to outpouching of posterior pharyngeal wall, just above upper esophageal sphincter) may occur; longitudinal muscle distally is continuous with longitudinal muscle of stomach; esophageal circular muscle continues as middle circular and inner oblique muscles of stomach
  • Adventitia: loose connective tissue; no consistent serosa so tumors and infections spread readily; majority of esophagus is surrounded by fascia
Drawings

Images hosted on other servers:

Various layers

Microscopic (histologic) images

Images hosted on PathOut server:

Squamous epithelium:

Thin basal zone

Squamous epithelium with intraepithelial lymphocytes



Mucosa and submucosa:

Muscularis mucosae

Section of esophageal mucosa

Submucosal glands and ducts

Alcian blue


Esophageal musculature

Histologic features

Esophageal cardiac glands

Esophageal inlet patch



Images hosted on other servers:

Full thickness


Esophageal fold (trichrome)

Upper third

Squamous epithelium: monolayer basal cells

Mucosa and submucosa

Mucosa and submucosa: with squamous metaplasia