A.Y.

2019
Digestive tract Histology
to
Eduardo G. Gonzales, M.D. L.E. 5
01/28/2020 Trans 2
2020

GASTROINTESTINAL SYSTEM

→ Digestion (i.e., the breaking down of ingested food into

absorbable substances), absorption of digested
substances and excretion of undigested materials are the
functions of digestive system. It consists of the digestive
tract (alimentary canal) and the digestive glands.

I. DIGESTIVE TRACT

→ The digestive system has three functions which are:

• Digestion (most important)
o breaking down of food into simpler
substances
• Absorption 1. Mucosa
o assimilation of nutrients from A. Epithelium
digested material • varies from segment to segment
• Excretion B. Lamina propria
o elimination of indigestible materials • loose connective tissue with fine blood
and lymphatic vessels,GALT, and
A. COMPONENTS OF DIGESTIVE TRACT digestive glands
C. Muscularis mucosae
→ The tract does the mechanical digestion while the • poorly developed smooth muscle layer
glands perform chemical digestion. (ic; ol)
→ The tract is simply a long tube comprised of segments • sometimes absent
each with different morphology and functions. 2. Submucosa
→ It starts from the oral cavity, pharynx, esophagus, • loose connective tissue but denser and
stomach, small intestine, and large intestine usually more abundant than lamina
propria
I. DIGESTIVE GLANDS
• contains blood vessels that are larger
→ Digestive glands are glands that empty their than in lamina propria, GALT, and in
secretions into the tract lumen that are either some segments, digestive glands
embedded in the walls of the tract or accessory
• contains ganglionated autonomic
glands of the system.
neurons (submucous plexus of Meissner)
→ The secretions of accessory glands go through ducts 3. Muscularis Externa
that connect to the tract.
→ inner coat
→ Glands included are the salivary, liver, gall bladder, o circularly oriented muscle cells
and the exocrine part of the pancreas.
→ outer coat
o longitudinally oriented muscle cells
HISTOLOGIC LAYERS
→ cells of Cajal (ICC)
o in esophagus, small and large intestines
→ The tract has 4 histologic layers that are poorly
o located between nerves and smooth muscle
delineated in the first two segments of the tract but are
cells
well-defined from the esophagus onwards.
o act as pacemaker for intestinal motility
→ Starting from innermost: mucosa, submucosa, 4. Serosa/Adventitia
muscularis externa, and adventitia/serosa.
→ in areas with no peritoneal covering
→ with surrounding connective tissue

Histology REGALA and TORRES 1 of 7

L.E. 5 Trans 2 : Digestive tract

II. ORAL CAVITY → embedded in epithelium of:

→ Vestibule o circumvallate papillae
o area anterior to teeth and gums o fungiform papillae
→ Oral cavity proper o epiglottis
o Roof – hard and soft palate o soft palate
o Floor – tongue o palatoglossal arch
o posterior pharyngeal wall
II.A TONGUE → taste pore - opening into oral cavity
→ muscular organ → nerve supply
→ plays important role in: o facial nerve (CN VII) - supplies those on
o mastication and deglutition anterior tongue
o speech o glossopharyngeal nerve (CN IX) and, to a
o taste small extent, vagus nerve (CN X) - supply
those posterior to tongue and pharynx
HISTOLOGIC LAYERS → TYPES OF CELLS: (Under LM)
→ MUCOS o A. Sustentacular or supporting cell
• smooth in ventral aspect of tongue o B. Neuroepithelial or gustatory cell
• rough on dorsal aspect ▪ both slender and spindle-shaped
• epithelium is stratified squamous ▪ distal ends are covered by microvilli
→ SUBMUCOSA ▪ but the sustentacular cells are
• in ventral surface only darker staining than neuroepithelial
→ MUSCULARIS cells
o C. Basal cell
• skeletal muscles
▪ relatively undifferentiated cell that
PARTS OF THE TOUNGE
serves as stem cell for other cell
types
→ ANTERIOR - covered by LINGUAL PAPILLAE:
▪ Type I - many correspond to
sustentacular cells
Types:
▪ Type II and Type III - subsets of
1. Filiform - most numerous - all over anterior tongue -
nueroepithelial cells - most authors
slender, tapering projections: core of connective tissue
consider type III cells as gustatory
and covered w/stratified squamous epithelium (keratinized
cells though types I, II and III are all
at tips)
associated with nerve fibers.
▪ Type IV - correspond to basal cells
2. Fungiform - flattened surfaces - broader than filiform
▪ Type V - form outer boundary of
papillae - scattered among filiform papillae - grossly,
taste bud
pinhead-sized red dots because core contains many
capillaries - taste buds are occasionally present on surface
GLANDS
→ root and lateral surfaces
3. Circumvallate - arranged in a “V” along sulcus
o mucous glands
terminalis - largest (1-3 mm in diameter) - least numerous
o in lamina propria
(just 6-14) - taste buds (200-300/ papilla) on sides - base
o similar to buccal and labial glands
is surrounded by a canal or moat
→ glands of von Ebner
o serous, compound tubuloalveolar glands in
→ POSTERIOR - contains lingual tonsils
lamina propria in area of circumvallate
papillae
Types:
o ducts open into moat of circumvallate
1. Sulcus terminalis - inverted V-shaped shallow furrow-
papillae
demarcates anterior 2/3 from posterior 1/3
o secretions:
▪ continuously flush moat
2. Foramen cecum - apex of “V” represents remnants of
▪ medium where gustatory
thyroglossal duct from which thyroid gland originated
substances can be dissolved
TASTE BUDS → anterior lingual glands of Nuhn and Blandin
o in submucosa under apex of tongue mixed
→ organs of taste
glands
→ ovoid, pale structures
o like von Ebner’s glands, tubuloalveolar
glands
Histology REGALA and TORRES 2 of 7
L.E. 5 Trans 2 : Digestive tract

II.B PHARYNX o Body – continuation of fundus, bulk of the

o organ
→ Funnel shaped, fibromuscular tube o Pyloric region – tapering distal part; pyloric
→ Common to digestive and respiratory system antrum and canal -gastric pits very deep

II.C ESOPHAGUS HISTOLOGIC LAYER

→ MUCOSA
→ Passageway for food o Rugae – longitudinally anastomosing mucosal
→ Long tube (20 – 25 cm) folds (seen grossly)
→ Glands – mucous glands to minimize friction o Epithelium
o Simple columnar
HISTOLOGIC LAYER o Gastric folveolar or pits
→ MUCOSA o Invaginations of epithelium
o Epithelium – stratified squamous non-keratinized o 2-4 mm apart and anastomose with
o Gastroesophageal junction – epithelium changes o each other extensively
to simple columnar – referred to as Z line
(esophageal carcinomas) o Cells
o Langerhans cells – antigen presenting cells; o Surface mucous cell
occasional in stratum germinativum o Enterendocrine cells – hormone producing
o Lamina propria cells
• Has GALT o Lamina propria
• Esophageal cardiac glands o Contains gastric glands (simple tubular or
simple branched tubular glands)
• Simple tubular glands – serous in nature
o Named according to location
• Find at initial or terminal part of
o Fundic glands
esophagus
• located in fundus and body of stomach
• Muscularis mucosa – more prominent in
• Principal gastric glands
lower part of esophagus
• most numerous
→ SUBMUCOSA • longer than cardiac and pyloric glands
o Usually thicker than lamina propria o Cardiac glands – cardiac region
o GALT • Least numerous of all glands
o Esophageal glands proper (mucous) • Enteroendocine cells: secrete gastrin
o Compound tubuloalveolar glands (G-cells)
• Mucous neck: numerous
→ MUSCULARIS EXTERNA • Few zymogenic and parietal cells
- Layers are not well delineated
o Inner – circularly arranged o Pyloric glands – pyloric region
o Outer - longitudinally arranged • Simple tubular but more coiled
o Upper third – skeletal muscles • Most numerous glands (mucous
o Lower third – smooth muscles secreting glands)
o Middle third – mixture of skeletal and • same as in fundic glands, but
smooth muscles • mucus-secreting cells are the most
→ ADVENTITIA/SEROSA numerous
o Adventitia except for portion inside abdomen – • few parietal cells
contains mesothelium • usually no zymogenic cells
→ CELLS FOUND IN THE GLAND:
II.D STOMACH o Oxyntic (parietal cell)
→ Gross Divisions: • most recognizable
o Cardiac region – immediately • produces HCl
surrounding gastroesophageal opening • important in absorption of vitamin B12
- pits & glands occupy same amount of • done in ileum
space o Zymogenic (chief) cell
o Fundus - dome shaped part above horizontal • most numerous in deeper region of
plane of esophageal opening glands
- mucosa occupied mostly by glands together • produces secretory material that
with body
• contains enzymes (pepsinogen)
Histology REGALA and TORRES 3 of 7
L.E. 5 Trans 2 : Digestive tract

o Mucous neck cell
• confined to the upper region of the glands,
near the gastric pit
• contains mucigen granules
o Stem cell
• replenishes cells
• mostly found at the upper part of the
glands
o Enteroendocrine cells
• 1% of epithelial cell population of
• stomach and intestine
• argentaffin cells (affinity to silver
• stains)
• largest endocrine part of the body
o G cells – gastrin
o EC cells – serotonin
o D cells – somatostatin
o Muscularis mucosa
→ SUBMUCOSA
o Thick connective tissue and no glands
→ MUSCULARIS EXTERNA
o Inner obliquely muscle cells
o Middle circularly arranged
o Outer longitudinally arranged
o Myenteric plexus of auerbach –between the
longitudinally and circularly arranged fibers
→ SEROSA (entire)
→ GASTRIC MUCOSAL BARRIER
o Prevents HCl and gastic enzymes from damaging
gastric mucosa
o Components:
• Compact epithelium – tight junctions (zonula
occludens)
• Layer of mucous over mucosal surface –
product of surface mucous and mucous neck
cells
• Bicarbonate ions – produced by surface
mucous cells
▪ Neutralizes HCl as soon as Pepsin
has stopped performing its function
II. E SMALL INTESTINE
→ Average length of 6-10 meters Anchored to posterior
body wall by means of mesentery
→ Has 3 segments, from most proximal to most distal:
• Duodenum
• Jejunum
• Ileum
→ Duodenum forms the first 25 cm of the small intestine
while jejunum comprises 2/5 and the ileum 3/5 of the
remainder of the organ
→ Stomach contents (chyle) are intermittently
introduced into duodenum via pyloric sphincter, a
strong ring of smooth muscle at the end of the pyloric
canal
→ In the small intestine, digestion is more or less
completed
→ Also in this segment, most (90%) of the nutrients from
digested food, as well as water, are absorbed
MODIFICATIONS OF MUCOSA AND SUBMUCOSA
→ Exhibits modifications that are designed to increase
the surface area of the organ in contact with food
that’s being digested and absorbed
→ Modifications include: horizontal mucosal folds,
intestinal villi, and microvilli
→
o Horizontal Muscosal Folds or Valves of
Kerckring
• Luminal surface of the small intestine, when
examined by naked eye, is not smooth but
wrinkled, these are cresentic or circular
horizontal creases called horizontal
mucosal folds that consists of a core of
submucosa and overlying mucosa
• Most developed in jejunum
• Absent in first part of duodenum and the
distal part of ileum
o Intestinal Villi
• Mucosa of small intestine including that which
lines the horizontal mucosal folds and area in
between the folds form finger-like projections
called intestinal villi
• Consists of a core of lamina propria
enveloped by epithelium
o Lamina propria contains loose
connective tissue elements and
lymphocytes, core of a villus contain
few longitudinally-oriented smooth
muscle cells, blood capillaries, and
lymphatic capillaries called lacteals
o Lacteal is a blind tube that starts near the
tip of the intestinal villus, and lacteals
unite with other lacteals to form lymphatic
vessels
• Numerous in proximal segments of the small
intestine
• Gradually decrease as one goes in the distal
portion of the ileum

Histology REGALA and TORRES 4 of 7

L.E. 5 Trans 2 : Digestive tract
• Villi shape vary in shape as one proceeds
distally, from broad and tongue-like in the
duodenum to narrow and finger-like in the
ileum
→ Microvilli
• Epithelial cells that comprise the surface
epithelium of the small intestine have
microvilli on their apical surfaces
• Identical to those present in other cells that
exhibit them
EPITHELIUM OF SMALL INTESTINE
→ Surface epithelium of the small intestine is simple
columnar
→ Populated by four types of cells:
• Enterocytes
• Goblet cells
• Enteroendocrine cells
• M-cells
→ All four cell types contain microvilli on their luminal
surface, but the microvilli are most numerous in
enterocytes where they number up to 3,000/cell
→ Microvilli on epithelial cells are not individually
distinguishable under the light microscope, but
collectively, they form a striated area called brush
border or striated border
→ Among epithelial cells in the small intestine are T cells
called intrapepithelial lymphocytes (IEL), these
lymphocytes are part of intestinal GALT but are
functionally different from lymphocytes in lamina
propria because they don’t need prming; they
immediately release their cytokines in presence of
antigens
• Concerned with local immunity as well as
immunity to new growths in the intestines
• Increase in number if there is ongoing mucosal
inflammation such as celiac disease and in the
presence of tumors such as colorectal cancers
• Also found in the skin and within the epithelial
layer that lines the large intestine, biliary tract,
oral cavity, upper respiratory tract and lungs, and
reproductive tract
• Largest production of IEL resides within the
epithelium of the small intestine
→ Cells
• Enterocytes
o Vast majority of cells in surface epithelium of
small intestine
o Tall columnar cells whose nucleus is typically
in the basal part of the cell
o Absorptive cells that are responsible for taking
up nutrients from the intestinal lumen and
transporting these substances across the
epithelium to the lamina propria, where they
diffuse into blood and lymphatic capillaries
Histology REGALA and TORRES
o
Goblet cells
▪ Interspersed among enterocytes
▪ Increase in number as one goes distally in
the small intestine
o Enteroendrocrine cells
• Present in entire surface epithelium of small
intestine
• But are few and far between
o M cells
• Also as membranous cells or microfold cells
• Present only in areas where there’s great
concentration of GALT in the lamina propria
and submucosa, such as ileum
• Large cells with relatively few microvilli
• Basolateral cell membrance forms
indentations that are occupied by
lymphocytes
• Also are antigen-presenting cells, rapidly
endocytose antigens from the intestinal
lumen, transport these in the form of vesicles
across their cytoplasm, and exocytose them
into the indentations in their basolateral
membrane where lymphocytes are present
HISTOLOGIC LAYER
1. MUCOSA
o Lamina Propria and Muscularis Mucosae of the Small
Intestine
o Lamina propria of small intestine consists of loose
connective tissues richly supplied with blood and
lymphatic vessels, nerves, and GALT in the form of
diffuse lymphoid tissue and occasional lymph nodules
o Has smooth muscle fibers some of which are
continuous with the muscle fibers of the muscularis
mucosae
o A host of cells that belong to body’s defense system is
present in the lamina propria that includes mast cells,
plasma cells, and macrophages as well as
lymphocytes
o In lamina propria, where intestinal gland or crypts of
Lieberkuhn are embedded
→ Crypts of Lieberkuhn (Intestinal Glands)
o Small intestinal epithelium between adjacent villi
invaginates into lamina propria for form simple tubular
glands called crypts of lieberkuhn that secrete a
variety of digestive enzymes
o Span entire thickness of the lamina propria and their
openings are found between the villi
o Five types of cells comprise the crypts of Lieberkuhn:
• Stem cells
• Enterocytes
• Goblet cells
• Paneth cells
• Enteroendocrine cells
5 of 7
L.E. 5 Trans 2 : Digestive tract
1. Stem Cells
o Most numerous
o Occupy middle region of glands
o Columnar cells but more basophilic than mature enter
o Responsible for regenerating the surface and
glandular epithelia
• When they divide, they do so to renew their
numbers or to differentiate into enterocytes,
enteroendocrine cells, goblet cells, or Paneth cells
• Resulting cells then either migrate up the crypts to
replace those cells that are on the surface
epithelium or descend to populate the basal part of
the glands
o Stem cells proliferate fast because of there is a rapid
turnover of epithelial cells in the small intestine
• Life span of epithelial cells (except for Paneth and
Enteroendocrine cells which can survive for weeks)
is approx. 4-6 days only
2. Enterocytes
o Most are destined to replace the enterocytes that are
on the surface epithelium
• After differentiating from stem cells, they move
towards luminal surface
• On their way to the surface, they divide several
times while at the same time, mature
▪ When they reach the surface epithelium, they
are mature enterocytes that are absorptive in
nature
• But while still in crypts, they are largely
secretory in function, secreting a variety of
enzymes that help complete the digestion of
proteins, carbohydrates, fats, and nucleic acid
3. Goblet Cells
o Similar to their counterparts in the surface
epitheliumocytes in routine histologic sections
o Relatively few in the crypts of Lieberkuhn
o Confined to the upper portions of the glands
4. Paneth Cells
o Comprise population of cells in the basal parts of the
crypts of Lieberkuhn
o In routine histologic preparations, they appears as
large, pyramidal cells that have basophilic basal
cytoplasm and coarse eosinophilic granules in their
apical cytoplasm
o Secrete a variety of antimicrobial peptides into
intestinal lumen
• These peptides destroy enteric pathogens and
dictate composition of the microbial colonies in
the small intestine
• Also contribute to intestinal homeostasis
because their dysfunction is associated with
the occurrence of inflammatory bowel disease,
Crohn’s disease
5. Enteroendocrine Cells
o Present singly in the crypts of Lieberkuhn
Histology REGALA and TORRES
o Like those in stomach, enteroendocrine cells in the
small intestine produce gastrin, somatostatin, and
serotonin
o Also produce an assortment of other hormones
including enteroglucagon, cholecystokinin, gastric
inhibitory protein (GIP), motilin, neurotensin,
pancreatic polypeptide, and secretin
2. SUBMUCOSA
o Thick submucosa that’s richly supplied with blood
vessels, lymphatic vessels, and GALT
o Solitary lymphoid are common in GALT that’s
ubiquitous in the submucosa of the entire small
intestine
o In ileum, especially in anti-mesenteric side, lymphoid
nodules are particularly large and numerous, they
form aggregates called Peyer’s Patches that extend
into the lamina propria
o Lymphoid nodules in the Peyer’s patches are
longitudinally-oriented oval bodies that are sometimes
involved in disease processes such as typhoid fever
where they may ulcerate
o Submucosal glands are only present in duodenum,
these glands are called Brunner’s glands (duodenal
glands) are compound coiled, tubular, mucus-
secreting gland
o Ducts open into bottom of the crypts of Lieberkuhn
and occasionally in between villi
o Aside from secreting alkaline mucus that help
neutralize the acidity of chime, Brunner’s gland
secrete epidermal growth factor (EGF; urgastrone), a
hormone that’s secreted in greater amounts by the
major salivary glands
3. MUSCULARIS EXTERNA
o Muscularis externa of the small intestine is typical
(inner concentric layer and outer longitudinal layer)
but it’s thicker in the proximal than in the distal portion
of the organ
4. SEROSA/ADVENTITIA
o Most external histologic layer of the small intestine is
the serosa, except for the posterior aspect of the 2nd
and 3rd segments of the duodenum which is not
covered by peritoneum and is thus simply adventitia
II. F LARGE INTESTINE
→ last part of digestive tract
→ 1.5 - 1.6 m long
6 of 7
 L.E. 5 Trans 2 : Digestive tract

→ segments: MUSCULARIS EXTERNA

o cecum and vermiform appendix o Tenae coli
o ascending colon • outer layer of longitudinally-arranged smooth
o transverse colon muscle fibers form three narrow bands
o descending colon • about 1 cm in width each and equidistant from
o sigmoid colon each other
o rectum • between tenia coli, longitudinal muscle layer thin
o anal canal or absent
→ Differs from small intestine because of: • reverts to typical muscularis externa in rectum
o sacculations or haustra 4. SEROSA/ADVENTITIA
o appendices epiploicae o serosa mostly
o teniae coli o adventitia only in parts of ascending colon and
→ Has no mucosal folds except for: descending colon that press directly on posterior body
o Transverse Rectal Folds wall
• 2-3 mucosal folds in proximal part of rectum o in serosa – adipose tissue form pendulous masses
o Rectal Columns of Morgagni called appendices epiploicae
• longitudinal mucosal folds in anal canal
II. G VERIFORM APPENDIX
HISTOLOGIC LAYER
MUCOSA → short (ave = 8 cm), worm-like evagination of cecum
o no villi
o no mucosal folds HISTOLOGIC LAYER
o Epithelium
• simple columnar → MUCOSA
• level of rectal columns of Morgagni abruptly o Epithelium
replaced by stratified squamous epithelium that • tall columnar cells with microvilli
keratinizes on anal verge • few goblet cells
→ Epithelium: Cells: • few enteroendocrine cells
o Enterocytes o Lamina Propria
• majority of cells • heavily infiltrated with lymphocytes
• absorptive in nature • with lymphatic nodules
• shorter microvilli than in small intestine • crypts of Lieberkuhn
o Goblet Cells o short
• more numerous than in small intestine o occasional Paneth cells
• enteroendocrine cells o muscularis mucosa
• fewer than in small intestine o poorly developed
• secrete glucagon, serotonin, somatostatin → SUBMUCOSA
and pancreatic polypeptide o Thick
o M-cells o heavily infiltrated with lymphoid tissue
• similar to those in small intestine → MUSCULARIS EXTERNA
→ Lamina Propria o complete but thin
• GALT has more lymphoid nodules than small → 4. SEROSA
intestine and can extend to submucosa o completely enveloped by peritoneum
• crypts of Lieberkuhn compared to small
intestine: REFERENCES
▪ longer 1. Lecture Powerpoint
▪ more goblet cells 2. DLSHSI COM 2020 trans
▪ no Paneth cells 3. Doc Ed’s Histology Book
→ c. Muscularis Mucosae
o Typical
SUBMUCOSA
o richly supplied with GALT
o no glands

Histology REGALA and TORRES 7 of 7