Fine structure of the human fetal cervical ganglia

Dysmorphic Neurofilament-Positive Ganglion Cells in the Myenteric Plexus at the Proximal Resection Margin Indicate Worse Postoperative Prognosis in Hirschsprung's Disease

BACKGROUND

Hirschsprung's disease (HD) is a congenital disorder affecting neonates that presents with distal intestinal obstruction. It is the most common type of anorectal malformation. Treatment of HD consists of surgical removal of the distal colon including the most distal aganglionic segment, the transitional zone, and a prudent length of proximal colon that is determined during the surgical procedure to be normally ganglionated by intraoperative demonstration of normal ganglion cells up to and including the surgical resection margin.

METHODS

In a retrospective study of formalin-fixed paraffin-embedded colon tissue from the proximal resection margin (PRM) of 209 HD patients, we made morphometric measures and detected immature ganglion cells defined as dysmorphic by immunohistochemical demonstration of cytoplasmic neurofilament (NF).

RESULTS

The majority of NF-positive ganglion cells in HD patients appeared immature, with less cytoplasm. Occasional positive ganglion cells in the same patients appeared mature with abundant eosinophilic cytoplasm, Nissl bodies, prominent nucleoli, and adjacent glial cells. Patients with NF-positive ganglion cells in the myenteric plexuses at the PRM may have poor postoperative recovery.

CONCLUSION

We propose that NF expression in dysmorphic ganglion cells at the PRM may predict poor outcome after pull-through surgery for HD.

Glucocorticoid-induced PNMT-immunoreactive sympathetic cells in the superior cervical ganglion of the rat

Light and electron microscopic immunocytochemical techniques were used to study the effect of glucocorticoids on the development of phenylethanolamine-N-methyltransferase (PNMT)-immunoreactive cells in the superior cervical ganglion (SCG) of early postnatal rats. Rats were injected daily with hydrocortisone acetate on postnatal days 2-6. The first PNMT-immunoreactive cells were detected 6 hours after the first glucocorticoid injection and their number increased after subsequent injections. No PNMT-immunoreactive cells were detected in uninjected controls. PNMT-immunoreactive fibres were seen in the ganglion 6 hours after the first glucocorticoid injection. The PNMT-immunoreactive cells consistently showed processes 2 days after beginning the glucocorticoid treatment, and long processes and fibre networks were seen in ganglia of 7-day-old rats. However, no PNMT-immunoreactive fibres were seen in the iris, which is innervated by the SCG. Ultrastructurally, most of the PNMT-immunoreactive cells had the look of small granule-containing (SGC) cells, including heterochromatin clumps along the nuclear envelope and in the center of the nucleoplasm as well as dense core vesicles. SGC cells, nonimmunoreactive to PNMT antiserum, also were seen. However, some PNMT-immunoreactive cells showed ultrastructural characteristics of nerve cells. In contrast to the SGC cells, these cells were characterized by a voluminous cytoplasm, dispersed nuclear heterochromatin, and a lack of granular vesicles. These results demonstrate that glucocorticoids induce PNMT immunoreactivity both in SGC cells and also in cells with characteristics of principal neurons.

Fine-structural and degenerative features in adult and aged human sympathetic ganglion cells

Sympathetic ganglia, either cervical and upper thoracic or lumbar, were removed from adult and aged patients suffering from circulatory deficiencies in their upper or lower extremities, respectively. The ganglion cells had several features that can be associated with age. Lipofuscin was ample in all ganglion cells and was usually polarly concentrated. Its amount tended to increase with age and it was present also in the glial cells. Lipofuscin autofluorescence often prevented the visualization of the formaldehyde induced fluorescence for catecholamines. At the electron microscopic level, pigment bodies were seen to be composed of three different kinds of osmiophilic properties: (1) gray component that had (2) dark patches dispersed into it and (3) pale, oval, incorporated droplets. In principal ganglion cells, the first two formed the major part, the pale one taking over in the small granule-containing cells. Various inclusion bodies included a cylinder-shaped type that had a varying pattern of rod-like structures inside it. Myelin figures (laminar bodies) were sometimes found to fill neurite profiles, occasionally with random mitochondrial accumulations. These bore a distant resemblance to the primitive type of neuritic (senile) plaques, although none of the patients was diagnosed to have, for example, Alzheimer's disease or senile dementia of the Alzheimer type. Nevertheless, it appears to us that it might be possible to find coexistent neuropathological changes in peripheral sympathetic ganglia in diseases affecting primarily the central nervous system.