PMC5784575_01
Endoscopic full-thickness biopsy showing the complete wall of the sigmoid colon (periodic acid-Schiff-diastase stain). Arrow points to the myenteric plexus. MU, mucosa; CM, circular muscle; LM, longitudinal muscle.
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Histopathological examination confirmed a full-thickness resection (20 x 16 mm) showing changes in the myenteric ganglia (Figure 1).
Myenteric ganglion with neurons showing vacuolated cytoplasm (thick arrow) and a shrunken, darker, amphophilic, pre-apoptotic neuron also with a few vacuoles (thin arrow) (hematoxylin and eosin stain) (bar: 50 microm). Insert: large accumulation of lipofuscin granules within a neuron (thin arrow). Thick arrow points to a lacuna after lysis of a necrotized neuron with the nuclei of two glial cells (periodic acid-Schiff-diastase stain) (bar: 20 microm).
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Several neurons were hypertrophic/enlarged (50 microm), with or without vacuolated cytoplasm, whereas other neurons were shrunken with amphophilic cytoplasm and small hyperchromatic nuclei (Figure 2). Large lipofuscin granules accumulated in these neurons and a few lacunae after lysis of necrotized neurons were also observed (Figure 2), as well as enlarged nucleoli and chromatolysis in some neurons.