You are on page 1of 13

The lower gastrointestinal tract has as its principal function the reabsorption of ions and water from the

gut contents following nutrient absorption during passage through the small intestine. The appendix, the colon, and the rectum all share a common mucosal description, with many straight crypts but no villi, and with the epithelium consisting of many goblet cells interspersed among absorptive cells. The anal canal represents a transitional region, where the characteristics of the colon and rectal mucosa change to those of skin.

The mucosa of the appendix, colon, and rectum has a simple columnar epithelium shaped into straight tubular crypts. There are no villi. In cellular composition, the epithelium of the lower tract resembles that of the small intestine, but with a higher proportion of goblet cells interspersed among the absorptive cells. (The proportion of goblet cells is also higher in ileum than in jejunum and higher in jejunum than in duodenum.)

Although absorptive cells remain more numerous throughout the tract, goblet cells in the colon are so numerous and so large (bulging against the adjacent absorptive cells) that the colon epithelium sometimes appears to consist mostly of goblets.
The crypt epithelium also includes stem cells which replenish the epithelium every few days, enteroendocrine cells, and (in the cecum and proximal colon) Paneth cells.

The crypts are separated by conspicuous lamina propria, whose composition is similar to that of small intestine, loose connective tissue infiltrated by many white blood cells, with capillaries and thin strands of smooth muscle. Lymph nodules are a standard feature of the appendix but are normally relatively uncommon elsewhere in the lower tract. More frequent accumulations of lymphoid tissue are characteristic of chronic inflammatory bowel disease.

The muscularis mucosa of the lower tract forms a thin layer (only a few muscle fibers in thickness) beneath the deep ends of the crypts. The submucosa of the lower tract is relatively unspecialized. Muscularis externa of the colon has the standard layers of inner circular and outer longitudinal smooth muscle, with ganglia of Auerbach's plexus scattered in between. The longitudinal muscle is gathered into three distinct bands, the taenia coli. The outer layer of the colon is a serosa attached to mesentery

Three regions of the lower tract have very similar tissue architecture, the appendix, the colon, and the rectum. The fourth region, the anal canal, represents a transition where the characteristics of the colon and rectal mucosa change to those of skin. The wall of the appendix follows the same layered plan as the colon, albeit with a much small diameter. The surface epithelium surface and the crypts are practically identical to those of colon. However, the lamina propria of the appendix contains many lymph nodules and other, less organized lymphoid accumulations, so that it normally has an appearance which might suggest chronic inflammation if seen in the colon. In acute appendicitis, heavy leukocyte infiltration occurs throughout the wall of the organ.

The rectum has the same architecture as the colon, except for its location in the body wall rather than suspended in the peritoneal cavity. Thus its outer layer is adventitia rather than serosa. The anal canal represents a transition from features of the lower tract to those of skin. The surface changes from a simple columnar epithelium with goblet cells, through a short zone of non-keratinized stratified squamous epithelium, to the typical keratinized stratified squamous epithelium of epidermis. Lamina propria and muscularis mucosae disappear distally, and the connective tissue of submucosa changes to the dense fibrous tissue of dermis. This connective tissue contains both ordinary eccrine sweat glands and much larger apocrine sweat glands. Smooth muscle of the colon changes to striated muscle of the voluntary anal sphincter.

The mucosa of the colon is characterized by straight crypts with no villi. In this specimen, a portion of the mucosa on the right side of the image has been cut tangentially. In this area, crypts have been cut in cross section to yield a "field of daisies" appearance.

Note that when the plane of section cuts across a crypt, the crypt appears to be surrounded by lamina propria. In contrast, when villi are cut across, they appear as isolated islands in the lumen.
Note the large number of goblet cells (clear "bubbles") which characterize crypt epithelium.

Unless specially stained, the mucus in goblet cells appears as clear "bubbles" in crypt epithelium.

But note that epithelial nuclei are more numerous than the mucus blobs, indicating that absorptive cells remain the predominant cell type in colon epithelium (as also in the small intestine), even though they are crowded by goblets and hence inconspicuous.

In this specimen, the plane of section passes through a wrinkle in the wall, so that submucosa passes diagonally across the image with mucosa appearing on both sides.

When crypts are cut longitudinally (as in much of the mucosa in the upper portion of this image), the columns of lamina propria between the epithelium of adjacent crypts might be misinterpreted as villi. But note that the lumenal spaces within the crypts are uniformly narrow (when they are visible at all), not variable and often wide, as spaces between villi of the small intestine The prominent pink ovals in the submucosa are blood vessels filled with red blood cells.

The mucosa of the appendix, like that of the colon, is characterized by straight crypts with no villi.

However, unlike the colon, the appendix is also characterized by an abundance of lymphoid tissue, including numerous well-organized lymph nodules. The lymphoid accumulations tend to obliterate the muscularis mucosae and extend into the submucosa
In post-mortem specimens, it is not uncommon for the surface epithelium to be lost. Epithelium is then only preserved in the crypts, as in the specimen illustrated above.

This specimen has been stained with PAS (per-iodic acid, Schiff), so that mucus in goblet cells appears red. Note that epithelial nuclei are more numerous than the mucus blobs, indicating that absorptive cells remain the predominant cell type in colon epithelium (as also in the small intestine), even though they are crowded by goblets and hence inconspicuous.

The appearance of lamina propria beneath the muscularis mucosae indicates that the plane of section has cut through a wrinkle in the mucosa. That this layer is not submucosa is indicated by the large number of lymphocyte nuclei. The apparent thickness of the muscularis mucosae also suggests that it has been cut tangentially, as does its disappearance at the lower left corner of the image.

This specimen has been stained with PAS (per-iodic acid, Schiff), so that mucus in goblet cells appears red

However, unlike the colon, the appendix is also characterized by an abundance of lymphoid tissue, including numerous well-organized lymph nodules. The lymphoid accumulations tend to obliterate the muscularis mucosae and extend into the submucosa.

You might also like