Palisading-like arrangement of immature ganglion cell in myenteric ganglia is a unique pathological feature of immaturity of ganglia

Koichiro Yoshimaru, Akihiko Tamaki, Toshiharu Matsuura, Kenichi Kohashi, Keisuke Kajihara, Keiko Irie, Yuko Hino, Yasuyuki Uchida, Yukihiro Toriigahara, Yuki Kawano, Takeshi Shirai, Yoshinao Oda, Tatsuro Tajiri, Tomoaki Taguchi

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Immaturity of ganglia (IG), an allied disorder of Hirschsprung disease (AD-HSCR), develops as neonatal ileus, but the dysmotility spontaneously resolves after several months. The diagnosis of IG using HE staining is often difficult. We herein report a new pathological finding of IG called the ‘palisading-like pattern’, which may be helpful for improving the diagnostic accuracy. Methods: Cases of IG that were managed over the past 28 years were retrospectively reviewed. We investigated the clinical course and pathological findings for Hematoxylin-Eosin (HE) staining. The conventional diagnostic criteria for IG were (1) a normal or slightly increased number of ganglion cells and (2) ganglion cells with small nuclei. Results: Among the 155 cases, 28 were diagnosed with IG, and 10 were retrospectively confirmed by HE staining. A palisading-like pattern was confirmed at the time of the initial ileostomy (median age, 2.5 days), and the palisading-like pattern had completely disappeared by the time of stoma closure (median age, 215 days) in all 10 cases. A palisading-like pattern is not present in other diseases. Conclusions: Even if immunostaining data are not available for a further analysis, the detection of a palisading-like pattern on HE staining makes an accurate diagnosis possible. Level of evidence: LEVEL IV.

Original languageEnglish
Pages (from-to)1269-1273
Number of pages5
JournalJournal of Pediatric Surgery
Volume57
Issue number7
DOIs
Publication statusPublished - Jul 2022

All Science Journal Classification (ASJC) codes

  • Surgery
  • Pediatrics, Perinatology, and Child Health

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