Palisade vessels as a new histologic marker of esophageal origin in ER specimens from columnar-lined esophagus

Am J Surg Pathol. 2011 Aug;35(8):1140-5. doi: 10.1097/PAS.0b013e3182206c0e.


It is difficult for surgical pathologists to determine the origin of tissues in samples taken from the columnar-lined esophagus (CLE) or stomach by biopsy or endoscopic resection (ER) on the basis of histologic examination alone. We examined histopathologically a single section (5 to 22 mm in size; mean, 12 mm) from each of 66 cases of CLE (36 short segments, 30 long segments) from German patients with reference to 3 histologic markers of esophageal origin: esophageal glands proper and/or ducts, squamous islands, and double muscularis mucosae, all of which had been reported previously, and palisade vessels as a new histologic parameter as well. Palisade vessels were defined histologically as veins >100 μm in size in and above the original muscularis mucosae. Esophageal glands proper and/or ducts, squamous islands, and double muscularis mucosae were seen in 33%, 18%, and 71% of the specimens, respectively. Palisade longitudinal vessels were observed in 78% and 63% of specimens of short-segment and long-segment CLE, respectively. Palisade vessels were never seen in ER specimens from the stomach or in the middle esophagus and stomach among control autopsy specimens. At least 1 of these 4 markers was seen in 88% of the sections. Therefore, ER specimens were confirmed to originate from CLE in 88% of single histologic sections of CLE on the basis of histologic examination alone.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Autopsy
  • Biopsy
  • Carcinoma / blood supply*
  • Carcinoma / pathology
  • Carcinoma / surgery
  • Case-Control Studies
  • Esophageal Neoplasms / blood supply*
  • Esophageal Neoplasms / pathology
  • Esophageal Neoplasms / surgery
  • Esophagogastric Junction / blood supply*
  • Esophagogastric Junction / pathology
  • Esophagogastric Junction / surgery
  • Esophagoscopy
  • Esophagus / blood supply*
  • Esophagus / pathology
  • Esophagus / surgery
  • Female
  • Humans
  • Male
  • Metaplasia
  • Middle Aged
  • Mucous Membrane / blood supply
  • Mucous Membrane / pathology
  • Stomach / blood supply*
  • Stomach / pathology
  • Stomach / surgery
  • Stomach Neoplasms / blood supply*
  • Stomach Neoplasms / pathology
  • Stomach Neoplasms / surgery
  • Veins / pathology