Skip to main content
SpringerLink
Log in
Book cover

Colitis pp 5–24Cite as

The Normal Biopsy: Colonic and Ileal Mucosa and Submucosa

  • Chapter
  • First Online:

  • 1008 Accesses

Abstract

The digestive tract is a hollow tube consisting throughout of three coats or layers. The first layer, the mucosa, is made up of an epithelial lining which borders on the lumen of the bowel and rests upon a basement membrane, the lamina propria and the muscularis mucosae. The mucosa of the colon has a smooth surface and is composed of tubular parallel crypts embedded in a loosely arranged stroma. The mucosa of the ileum is composed of fingerlike villi and displays a number of specific features including the shorter villi and more epithelial goblet cells on the surface than the proximal small intestine and the presence of Peyer’s patches. The second coat is the submucosa. The muscularis propria, the third layer, is composed of two layers of smooth muscle separated by a thin layer of connective tissue in which the ganglionated myenteric plexus (Auerbach’s) can be observed. The subserosa is composed of loose areolar tissue covered by mesothelium where the tract borders on the body cavity (serosa). Endoscopic biopsies are limited to the mucosa and upper part of the submucosa. A good understanding of the normal histology of the mucosa and submucosa is essential for analysis of endoscopic biopsies of the ileum and the colon.

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Totafurno J, Bjerknes M, Cheng H. The crypt cycle. Crypt and villus production in the adult intestinal epithelium. Biophys J. 1987;52:279–94.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  2. Kudo S, Hirota S, Nakajima T, et al. Colorectal tumours and pit pattern. J Clin Pathol. 1994;47:880–5.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  3. Gledhill A, Cole FM. Significance of basement membrane thickening in the human colon. Gut. 1984;10:1085–8.

    Article  Google Scholar 

  4. Rubio CA, Kock Y. A digital quantitative method of estimating inflammation in the rectal mucosa: the normal limits in asymptomatic patients. Scand J Gastroenterol. 1981;16:731–5.

    Article  PubMed  CAS  Google Scholar 

  5. Levine DS, Haggitt RC. Normal histology of the colon. Am J Surg Pathol. 1989;13:966–84.

    Article  PubMed  CAS  Google Scholar 

  6. Sato T, Van Esh JH, Snippert HJ, et al. Paneth cells constitute the niche for Lgr5 stem cells in intestinal crypts. Nature. 2011;469:415–8.

    Article  PubMed  CAS  Google Scholar 

  7. Barker N, Van de Wetering M, Clevers H. The intestinal stem cell. Genes Dev. 2008;22:1856–64.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  8. Gersemann M, Stange EF, Wehkamp J. From intestinal stem cells to inflammatory bowel disease. World J Gastroenterol. 2011;17:3198–203.

    PubMed  PubMed Central  Google Scholar 

  9. Pang LC. Intussusception revisited clinicopathological analysis of 261 cases with emphasis on pathogenesis. South Med J. 1989;82:215–28.

    Article  PubMed  CAS  Google Scholar 

  10. Van Kruiningen HJ, West AB, Freda BJ, et al. Distribution of Peyer’s patches in the distal ileum. Inflamm Bowel Dis. 2002;8:180–5.

    Article  PubMed  Google Scholar 

  11. Shepherd NA, Crocker PR, Smith AP, Levison DA. Exogenous pigment on Peyer’s patches. Hum Pathol. 1987;18:50–4.

    Article  PubMed  CAS  Google Scholar 

  12. Eidelman S, Lagunoff D. The morphology of the normal human rectal biopsy. Hum Pathol. 1972;3:389–401.

    Article  PubMed  CAS  Google Scholar 

  13. Weber B, Saurer L, Mueller C. Intestinal macrophages: differentiation and involvement in intestinal immunopathologies. Semin Immunopathol. 2009;31:171–84.

    Article  CAS  PubMed  Google Scholar 

  14. Smith PD, Smythies LE, Shen R, et al. Intestinal macrophages and response to microbial encroachment. Mucosal Immunol. 2011;4:31–42.

    Article  PubMed  CAS  Google Scholar 

  15. Selby WS, Poulter LW, Hobbs S, et al. Heterogeneity of HLA-Dr positive histiocytes in human intestinal lamina propria: a combined histochemical and immunohistological analysis. J Clin Pathol. 1983;36:379–84.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  16. Sagaert X, Tousseyn T, De Hertogh G, Geboes K. Macrophage related diseases of the gut: a pathologist’s perspective. Virchows Arch. 2012;460:555–67.

    Article  PubMed  Google Scholar 

  17. Bejarano PA, Aranda-Michel J, Fenoglio-Preiser C. Histochemical and immunohistochemical characterization of foamy histiocytes (muciphages and xanthelasma) of the rectum. Am J Surg Pathol. 2000;24:1009–15.

    Article  PubMed  CAS  Google Scholar 

  18. Pascal RR, Gramlich TL, Parker KM, Gansler TS. Geographic variations in eosinophil concentration in normal colonic mucosa. Mod Pathol. 1997;10:363–5.

    PubMed  CAS  Google Scholar 

  19. Polydorides AD, Banner BF, Hannaway PJ, Yantiss RK. Evaluation of site-specific and seasonal variation in colonic mucosal eosinophils. Hum Pathol. 2008;39:832–6.

    Article  PubMed  CAS  Google Scholar 

  20. Powell N, Walker MM, Talley NJ. Gastrointestinal eosinophils in health, disease and functional disorders. Nat Rev Gastroenterol Hepatol. 2010;7:146–56.

    Article  PubMed  Google Scholar 

  21. Jakate S, Demeo M, John R, et al. Mastocytic enterocolitis: increased mucosal mast cells in chronic intractable diarrhea. Arch Pathol Lab Med. 2006;130:362–7.

    PubMed  Google Scholar 

  22. Seldenrijk CA, Morson BC, Meuwissen SGM, et al. Histopathological evaluation of colonic mucosal biopsy specimens in chronic inflammatory bowel disease: diagnostic implications. Gut. 1991;32:1514–20.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  23. Seki T, Naito I, Oohashi T, et al. Differential expression of type IV collagen isoforms, alpha5(IV) and alpha6(IV) chains in basement membranes surrounding smooth muscle cells. Histochem Cell Biol. 1998;110:359–66.

    Article  PubMed  CAS  Google Scholar 

  24. Kiesslich R, Burg J, Vieth M, et al. Confocal laser endoscopy for diagnosing intraepithelial neoplasias and colorectal cancer in vivo. Gastroenterology. 2004;127:706–13.

    Article  PubMed  Google Scholar 

  25. Fenoglio CM, Kaye GL, Lane N. Distribution of human colonic lymphatics in normal, hyperplastic, and adenomatous tissue. Gastroenterology. 1973;64:51–66.

    PubMed  CAS  Google Scholar 

  26. Rahier JF, De Beauce S, Dubuquoy L, et al. Increased lymphatic density and lymphangiogenesis in inflammatory bowel disease. Aliment Pharmacol Ther. 2011;34:533–43.

    Article  PubMed  Google Scholar 

  27. Tunru-Dinh V, Wu ML. Intramucosal ganglion cells in normal adult colorectal mucosa. Int J Surg Pathol. 2007;15:31–7.

    Article  PubMed  Google Scholar 

  28. Kayaselcuk F, Serin E, Gumurdulu Y, Ozer B, Tuncer I, Boyacioglu S. Subepithelial basement membrane thickness in patients with normal colonic mucosal appearance in colonoscopy: results from southern Turkey. World J Gastroenterol. 2004;10:1056–8.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Kirby JA, Bone M, Robertsoon H, Hudson M, Jones DE. The number of intraepithelial T cells decreases from ascending colon to rectum. J Clin Pathol. 2003;56:158.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  30. Tanaka M, Saito H, Kusumi T, Fukuda S, Shimoyama T, Sasaki Y, Suto K, Munakata A, Kudo H. Spatial distribution and histogenesis of colorectal paneth cell metaplasia in idiopathic inflammatory boel disease. J Gastroenterol Hepatol. 2001;16:1353–9.

    Article  PubMed  CAS  Google Scholar 

  31. Simmonds N, Furman M, Karanika E, Phillips A, Bates AW. Paneth cell metaplasia in newly diagnosed inflammatory bowel disease in children. BMC Gastroenterol. 2014;14:93.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Schreiber S, Raedler A, Stenson WF, MacDermott RP. The role of the mucosal immune system in inflammatory bowel disease. Gastroenterol Clin N Am. 1992;21:451–502.

    CAS  Google Scholar 

  33. Brandtzaeg P, Nilssen DE, Rognum TO, Thrane P. Ontogeny of the mucosal immune system and IgA deficiency. Gastroenterol Clin N Am. 1991;20:397–439.

    CAS  Google Scholar 

  34. Mulholland MW, Delaney JP. Neutropenic colitis and aplastic anemia: a new association. Ann Surg. 1983;197:84–90.

    PubMed  PubMed Central  CAS  Google Scholar 

  35. Geboes K, Dalle I. Influence of treatment on morphological features of mucosal inflammation. Gut. 2002;50(Suppl 3):III37–42.

    PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Pathology, Cliniques Universitaires St Luc, UCL, Brussels, Belgium

    Anne Jouret-Mourin

  2. Department of Pathology, Ziekenhuis Oost-Limburg ZOL, Genk, Belgium

    Peter Van Eycken

  3. Departments of Pathology and Surgical Sciences, University Hospital San Giovanni di Dio, University of Cagliari, Cagliari, Italy

    Maria Leo

  4. Department of Pathology, Ghent University Hospital, Ghent, Belgium

    Karel Geboes

  5. Department of Pathology, KU Leuven, Leuven, Belgium

    Karel Geboes

Authors
  1. Anne Jouret-Mourin
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Peter Van Eycken
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Maria Leo
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Karel Geboes
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Pathology Department, Cliniques Universitaires Saint-Luc, UCL-Brussels, Brussels, Belgium

    Anne Jouret-Mourin

  2. Department of Pathology, University of Cagliari, Cagliari, Italy

    Gavino Faa

  3. Department of Pathology, Ghent University Hospital, Ghent, Belgium

    Karel Geboes

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG, part of Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Jouret-Mourin, A., Van Eycken, P., Leo, M., Geboes, K. (2018). The Normal Biopsy: Colonic and Ileal Mucosa and Submucosa. In: Jouret-Mourin, A., Faa, G., Geboes, K. (eds) Colitis. Springer, Cham. https://doi.org/10.1007/978-3-319-89503-1_2

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-89503-1_2

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-89502-4

  • Online ISBN: 978-3-319-89503-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation