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Palisade Vessels as a New Histologic Marker of Esophageal Origin in ER Specimens From Columnar-Lined Esophagus

Aida, Junko DDS, PhD*; Vieth, Michael MD; Ell, Christian MD; May, Andrea MD; Pech, Oliver MD; Hoshihara, Yoshio MD§; Kumagai, Youichi MD; Kawada, Kenro MD; Hishima, Tsunekazu MD; Tateishi, Yoko MD; Sawabe, Motoji MD; Arai, Tomio MD; Matsuura, Masaaki PhD**; Takubo, Kaiyo MD*

The American Journal of Surgical Pathology: August 2011 - Volume 35 - Issue 8 - p 1140–1145
doi: 10.1097/PAS.0b013e3182206c0e
Original Articles

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.

*Research Team for Geriatric Pathology, Tokyo Metropolitan Institute of Gerontology

§Clinic of the Ministry of Economy, Trade, and Industry

Department of Pathology, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital

Department of Pathology, Tokyo Metropolitan Geriatric Medical Center

**Bioinformatics Group, Genome Center and Department of Cancer Genomics, The Cancer Institute, The Japanese Foundation for Cancer Research, Tokyo

Department of Surgery, Ohta Nishinouchi Hospital, Fukushima, Japan

Institute of Pathology, Klinikum Bayreuth, Bayreuth

Department of Gastroenterology, Dr Horst Schmidt Clinic, Wiesbaden, Germany

Correspondence: Kaiyo Takubo, MD, Research Team for Geriatric Pathology, Metropolitan Institute of Gerontology, Sakae-cho 35-2, Itabashi-ku, Tokyo 173-0015, Japan (e-mail:

© 2011 Lippincott Williams & Wilkins, Inc.