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Физиология человека

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Tables

Table 1 Frequently used histological stains

Stain	Mayer HE	Heidenhain azan	Masson-Goldner trichrome

Staining agent	Hematoxylin-eosin or hema-	Azocarmine-orange	Iron hematoxylin, Ponceau
	lum-erythrosin	aniline blue G	acid fuchsin or azophloxin-orange
			G, acid green G

Cell nuclei	Blue	Red	Black-brown

Cytoplasm	Pale red	Reddish	Intense dark red

Connective tissue fibers
Reticular	–	Blue	Pale green
Collagen	Red	Blue	Green
Elastic	Soft pink	Orange-red	–

Hyaline cartilage	Pale blue, blue, violet	Pale blue(reddish)	Light green
intercellular matrix

Muscular tissue	Red	Red-orange	Orange-red (brown)

Erythrocytes	Orange-red	Orange-red	Orange-yellow

Lipids in adipocytes	Solubilized/removed	Solubilized/removed	Solubilized/removed

Table 2 Surface epithelia: classification

Epithelium	Examples
Single-layered (simple) squamous epithelium	Mesothelium (serosal epithelium), endothelium (inner
(including endothelium)	lining of the heart as well as blood and lymph vessels),
	posterior corneal epithelium, epithelial labyrinth, Bow-
	man’s capsule, amnion epithelium
Single-layered (simple) cuboidal epithelium	Secretory ducts, defined segments of the renal tu-
(isoprismatic epithelium)	bules, plexus choroideus, anterior lens epithelium,
	small bile ducts
Single-layered columnar epithelium
(cylindrical epithelium)
Without kinocilia	Stomach, small intestines, large intestines, gallblad-
	der, hepatic ducts, papillary ducts
With kinocilia	Oviduct (uterine tube), uterus, ventricular ependyma
Multilayered pseudostratified epithelium
(columnar epithelium)
Without kinocilia	Segments of secretory ducts
With kinocilia	Nasal respiratory region, airways
With stereocilia	Epididymal duct, vas deferens
Multilayered stratified squamous epithelium
Nonkeratinizing	Oral cavity, esophagus, anterior corneal epithelium,
	vocal fold, vagina, anus
Keratinizing	Epidermis, nasal vestibule, vermilion, filiform
	papilla
Transitional epithelium (urothelium)	Renal calyces, renal pelvis, ureter, urinary bladder

Van Gieson	Heidenhain iron	Weigert elastica stain	Mann methyl blue-	Romeis lipid stain
	hematoxylin		eosin
Iron hematoxylin-	Tanning with iron	Orcein or resorcin-	Eosin-methyl blue	Hematoxylin-
picric acid-acid	alum-hematoxylin	fuchsin-nuclear fast		Sudan III
fuchsin		red

Black-brown	Chromatin and	Red	Blue, nucleoli: red	Blue
	nucleoli: black

Yellowish brown	Slightly gray, gray	–	Violet, reddish	Pale gray-blue

–	Gray-green, yellowish	–	Blue	–
Red	Gray-green, yellowish	–	Blue	–
Yellow	Yellowish, gray	Brown-red or violet to	Orange-red	–
		black-blue

Red and yellow	Gray-grayish blue	–	Violet, reddish blue

Yellow	Black	–	Red	–

Yellow	Black	–	Red-orange	–

Solubilized/removed	Solubilized/removed	Solubilized/removed	Solubilized/removed	Orange-red

Table 3 Salivary glands: attributes of serous and mucous acini in light microscopy

(after O. Bucher and H. Wartenberg, 1989)

Salivary gland	Serous acinus	Mucous tubule
Total diameter	Smaller	Larger
Configuration	Acinus or serous demilunes	Tubulus
Lumen/clearance	Very narrow, stellate	Relatively wide, round
Configuration of the nucleus	Round	Flattened, sickle-shaped
Positioning of the nucleus	Basal	Basal, peripheral
Cytoplasm	Granulated apical region,	Light, honeycomb structure
	secretory granules
Cell borders	Diffuse	Clearly visible
Terminal bars	Rarely visible	Present, usually visible
(junctional complexes)
Secretory ducts	Intercellular	Absent

Tables

Table 4 Seromucous (mixed) salivary glands and lacrimal gland: morphological attributes

Glands	Acini	Intermediary	Secretory ducts	Other attributes
		ducts
Parotid gland	Acinar, purely serous,	200–300 μm	Well-formed, in-	Stroma often contains
	narrow lumen	long, multiple	tralobular, bran-	adipocytes, abundant
		levels of branch-	ched	nerves
		ing

Submandibu-	Tubuloacinar, mixed	Some ducts are	Well-formed, in-	Areas with purely serous
lar gland	seromucous, predomi-	short and un-	tralobular, bran-	acini
	nantly serous, mucous	branched,	ched
	tubules with serous de-	others are long
	milunes	and branched

Sublingual	Tubuloacinar, mixed	Rarely present	Very short se-
gland	seromucous, predomi-		cretory ducts
	nantly mucous, branched
	mucous tubules with
	serous demilunes

Areas with purely mucous acini, lobed intermediary ducts filled with mucus

Pancreas	Acinar, purely serous	Well-formed	Absent	Endocrine glands: Lan-
	with central acinar cells,			gerhans islets (may be
	small myoepithelial cells			absent in the pancreatic
				head), few adipocytes

Lacrimal gland Serous, branched tu-		Absent	Absent	Abundant connective
	bules, wide lumen			tissue stroma with many
				free cells (lymphocytes
				and plasma cells

Tables

Table 5 Connective tissue fibers: morphological attributes

Type of fiber	Collagen fibers	Elastic fibers	Reticular fibers
Arrangement	Fiber bundles, weaves of	Fiber networks, fenes-	Very delicate webs, matrix
	various types of networks,	trated membranes, iso-	fibers at interfaces—e.g., be-
	variable mesh sizes, thick-	lated fibers, web lamel-	tween parenchymal cells and
	ness: 1–12 μm	lae. thickness: up to	connective tissue, basal
		18 μm	membrane, thickness:
			0.2–1.0 μm
Structure in light	Anisotropic fibers (no light	Isotropic (strongly light-	Thinner fibers, weak aniso-
microscopy	refraction observed), with	refracting) fibers, homo-	tropy; thinner fibers are
	cross-striation, not argyro-	geneous, anisotropic	clearly visible only after silver
	philic	stretched fibers, not ar-	impregnation (argyrophilic
		gyrophilic	fibers); positive PAS
			reaction

Structure in electron	Fibrils—microfibril	Microfibrils—diameters	Same as collagen fibrils, re-
microscopy	bundles, microfibrils built	are 10–14 nm, or amor-	ticular microfibrils are about
	from primary filaments,	phous elastin; no perio-	50 nm thick
	cross-striation of the	dicity
	microfibrils with a perio-
	dicity of 64 nm

Mechanical	Fibers have tensile strength	Reversibly expandable by	Moderately expandable
attributes	but do not stretch	100–150%

Chemical
attributes
Effect of weak	Swelling	No swelling	Slight swelling
acids
Effect of weak	Decomposition	Resistant	Low degree of
alkali			decomposition
Effect of boiling	Soluble, forms a glue	Insoluble	Insoluble
water

Tables

505

Table 6 Biological “fibers”: nomenclature

Connective tissue fibers	specific structured constituents of the intercellular
	matrix
Collagen fibers	Collagen fibers are birefringent in polarized light. They form fascicles (fas-
	ciculi collagenosi). When boiled in water, they form glue, such as bone glue.
	Collagen fibers occur in all connective and supportive tissue

Reticular fibers	Structured constituents of the intercellular matrix in reticular connective
	tissue, positive PAS reaction

Argyrophilic fibers	Thinner reticular fibers, which can only be seen using the silver impregnation
	technique, delicate matrix fibers, for example

Elastic fibers	Shiny fibers, strongly refract light in unstained preparations; the fibers branch
	and form meshworks, web lamellae and elastic membranes, contain elastin
	and microfibrils about 12 nm thick

Sharpey fibers	Collagen fibers, which radiate from the periosteum into the bony tissue, they
	secure the attachment of tendons, bands and periosteum to the skeleton

Tomes fibers	Processes of odontoblasts that are located in the dentine canaliculi (dentine
	fibers), also cellular structures

Lens fibers	Lens epithelial cells that have grown longitudinally and lost their nuclei;
	lens fibers can be up to 10 mm long. They are the major components of the
	lens

Glial fibers	Processes of certain macroglial cells

Nerve fibers	Processes of nerve cells—i.e., axons and their sheaths (oligodendrocytes
	for central nervous system fibers, Schwann cells for peripheral nerve
	fibers)

Smooth muscle fibers	Muscle cells or bundles often are erroneously called muscle fibers

Striated muscle fibers	Smallest building units of the skeletal musculature, multinucleated tubular
(skeletal muscle fibers)	syncytia

Heart muscle fibers	Incorrect name for heart muscle cells; often also used for a strand (cord) of
	apposed heart muscle cells

Purkinje fibers	Subendocardial termini of the nervous system of the heart, specific muscle
	cells

Tables

506

Table 7 Exocrine glands: principles of classification (after Sobotta/Hammersen, 2000)

Morphological	Classification		Examples
criteria
Number of secretory	Unicellular glands, multicellular glands		Goblet cells
cells			Salivary glands

Localization of the	Intraepithelial (endoepithelial)		Goblet cells
secretory cells	glands		Olfactory glands
	–	Unicellular glands	All large exocrine glands
	–	Multicellular glands
	–	Extraepithelial (exoepithelial)
		glands

Mode of secretion	Eccrine		Salivary gland, pancreas, lacrimal gland
	Apocrine		mammary gland, prostate gland, olfac-
			tory gland

Type of secretory	Holocrine		sebaceous glands, parotid gland, pan-
product	Serous – serous glands		creas, lacrimal gland, goblet cells, car-
	Mucous – mucous glands		diac glands, pyloric glands, duodenal
	Mucoid – mucoid glands		glands, vestibular gland, urethral glands

Shape of the acini	Tubular glands		Intestinal glands (mostly branched tu-
			bules), glands of the colon (colon
			crypts), uterine glands, eccrine and apo-
			crine sweat glands (if the tubules are
			coiled: coiled glands)
	Acinar glands		Parotid gland, pancreas
	Alveolar glands		Scent glands
	Tubuloacinar glands		Lacrimal glands, submandibular glands,
			sublingual glands
	Tubuloalveolar glands		Mammary glands, prostate gland

Presence and morpho-	– Simple glands: each acinus ends sep-		Sweat glands
logy of secretory ducts		arately on the epithelial surface	Pyloric glands
	– Branched glands: glands with several		All large salivary glands
		levels of branching; several acini con-
		nect to an unbranched secretory duct
	– Mixed (seromucous) glands: the elab-

orately branched secretory ducts end in one acinus

Tables

507

Table 8 Muscle tissue: distinctive morphological features

Muscle	Smooth musculature	Skeletal musculature		Heart musculature
tissue
Com-	Thin, spindle-shaped	Type I fibers (red	Type II fibers (white	Cell (cell territory be-
ponents	single cells	fibers)	fibers)	tween intercalated disks)

Nuclei per	One nucleus, length:	Many hundred nuclei,	Many hundred nu-	One or two nuclei, length:
cell	8–25μm	length: 5–16 μm	clei, length:	10 12μm
			5–16 μm
Shape and	Oval, rod-shaped to	Long, flat, peripheral,	Long, flat, periphe-	Plump, round to oval,
position of	elliptic, central	underneath the sarco-	ral, underneath the	often lentil-shaped nu-
nuclei		lemma	sarcolemma	clei, central with fibril-
				free cytocenter

Length of	40–200 μm, up to	Up to 40 cm	Up to 40 cm	50–150 μm
compo-	800 μm in the uterus
nents	during pregnancy

Diameter	5–15 μm	10–50 μm	80–100 μm	10–120 μm
of compo-
nents

Other	Longitudinal section:	Longitudinal section:	Less capillarization,	Components form web-
features	cells occur in slightly	striation; cross-sec-	fewer mitochon-	like structures (heart
	undulating bundles;	tion: myofibril mo-	dria, thin Z disks	muscle fibers); cross-sec-
	cross-section: nuclei	saics, dense capillariz-		tion: myofibril mosaic, en-
	are not sectioned in	ation, many mito-		doplasm, fibril-free cy-
	every cell, no myofi-	chondria, wide Z disks		tocenters, lipofuscin in-
	bril mosaics			clusions

Tables

508

Table 9 Stomach: differential diagnosis of the various segments of the stomach. Gastric areas (raised areas) and foveolae of variable depth with uniform prismatic epithelial cells up to 40 μm high are found in all segments of the stomach. These epithelial cells produce the gastric

mucus (not goblet cells). There are also smooth muscle layers with the form and organization that are characteristic of the intestinal canal. However, oblique fibers (inner face) are also present

Stomach	Cardiac portion with	Body and fundus of the stomach	Pyloric portion of the stomach
segment	cardial glands	with gastric glands	with pyloric glands
Gastric	Relatively deep foveolae,	Short foveolae: long, relatively	Deep foveolae: short, winding
glands	elaborately branched tu-	stretched tubules, mostly un-	tubules with wide lumina and
	bules with an irregular ap-	branched, but bifurcated at the	branched termini, on average
	pearance, often distended	fundus, narrow lumen	not quite so densely packed
	to ampulla, loosely struc-
	tured

Unicellular	Homocrine glands (one	Homocrine glands (secreting	Homocrine, mucus-producing
glands	secretory product =	mucus, exclusively) in the foveo-	gland cells, sporadic endocrine
	mucus), sporadic endo-	lae, heterocrine glands in the tu-	cells
	crine cells	bules, 3 different cell types: mu-
		cous neck cells, {chief) peptic
		cells and parietal cells

Special	Lamina propria recessed	Lymph follicles are absent, but	Cell-rich lamina propria in the
morpho-	against the gastric glands,	many free cells between gland	upper two-thirds of the mu-
logical fea- sporadic lymph follicles		tubules	cous membrane; between
tures			fundus and pylorus, there is an
			intermediary layer about 1 cm
			wide, with transitional forms of
			gastric and pyloric glands

Table 10 Intestines: differential diagnosis of the segments

Intestinal	Plicae	Intestinal villi	Intestinal crypts	Goblet cells	Special morphological
segment	circulares				features
Duodenum	Tall, wide	Dense, large	200–400 μm deep	Present	Mucoid duodenal glands
	circular	plump villi	tubular epithelial		(Brunner glands) in the sub-
	plicae (circu-		cells (Lieberkühn		mucosal tissue, including
	lar folds)		crypts = intestinal		plicae; there are small
			glands		groups of Paneth cells
					at the fundus of the
					crypts.

Jejunum	High, slen-	Long, slen-	Same as for the	Present	Increased presence of Pa-
	der, circular	der villi	duodenum		neth cells
	plicae

Ileum	Short circu-	Short, less	Deep crypts	Present	Increased presence of Pa-
	lar plicae,	dense villi			neth cells at the fundus of
	may be ab-				crypts, lymphatic nodules
	sent				opposite the adjoining
					mesentery branch (only
					visible in suitably cut prep-
					arations)

Colon	Rarely pres-	Absent	Dense population	Very	Hardly any Paneth cells any
	ent, but		of deep crypts	abundant	more; mitotic cells at the
	semilunar		(colon glands);		fundus of the crypts. The
	plicae		their depth in-		outer external tunica mus-
			creases closer to		cularis forms three tenia in
			the anus		the colon, plicae semilu-
					nares. Solitary lymphatic
					nodes break through the
					lamina muscularis mucosae;
					subserous lipid inclusions

Vermiform	Absent	Absent	Present, but absent	Abundant	Much smaller than the other
appendix			in some areas		intestinal segments, many
					lymphatic nodules (intesti-
					nal tonsils) in the tunica
					propria, which push
					through the lamina muscu-
					laris mucosae and often ex-
					tend to the inner circular
					muscle layer; mesenterio-
					lum

Rectum	Absent	Absent	400–800 μm, less	Copious
			dense population of	numbers
			deep crypts

Many solitary lymphatic nodules; the peritoneal lining is usually absent, in its place there is a tunica adventitia

Tables

509

Table 11 Kidney: tubules and their light microscopic characteristics

Part of the	Diameter	Epithelial cells	Cell nucleus	Affinity to stains	Basal striation
duct
Proximal tubule	50–60 μm	Pars convoluta:	Spherical, close	Strongly acido-	Pars convoluta:
		cuboidal, dif-	to the basal part	philic, diffuse	well developed
		fusely delimited	of the cell at dif-		pars recta: well
		surface, tall	ferent distances		developed, de-
		brush border,	from the base		creases toward
		cell borders			the interme-
		usually not visible			diary tubules
		pars recta: very
		tall brush
		border

Intermediary tu-	10–15 μm,	Extremely flat,	Lentil-shaped,	Light, neutro-	Absent
bule, descending	relatively	cell nuclei bulge	nuclei bulge into	philic, sometimes
and ascending	wide lumen	underneath the	the lumen	lipofuscin inclu-
limbs		surface, cell bor-	(more nuclei	sions
		ders not dis-	than in blood
		tinctly visible	vessels)

Distal tubule	Pars recta:	Lower than in	Pars recta:	Clearly stained,	Well developed
	25–35 μm;	the proximal	spherical to len-	acidophilic; how-
	pars convo-	tubules; no brush	til-shaped; pars	ever, lighter than
	luta:	border, therefore	convoluta: nu-	in the proximal
	40–45 μm	surface sharply	clei in a more	tubule
		delimited.	apical position
		Note: macula
		densa

Connecting	Approx. 25μm	Cuboidal, surface	Spherical	Light	Absent
tubule		is sharply
		delimited, sharp
		cell borders

Collecting tubule	40–200 μm	Ranging from	Spherical	Light,	Absent
system, cortical		cuboidal to col-		neutrophilic
and medullary		umnar, often
collecting ducts		slightly convex,
		very distinct
		regular cell bor-
		ders

Papillary ducts	200–300 μm	Columnar,	Spherical	Light,	Absent
		sharply delimited		neutrophilic
		surface, distinct
		cell borders

Tables

510

Table 12 Trachea and bronchial tree: morphological characteristics

Segment	Epithelial lining	Glands	Smooth musculature	Cartilage
Trachea (diameter:	Multilayered ciliated	Seromucous tra-	Tracheal muscle in the	Horseshoe-shaped
16–21 mm) and	columnar epithe-	cheal glands, pre-	membranous wall	hyaline tracheal
principal bronchi	lium with unicellular	dominantly be-		cartilage
(diameter:	endoepithelial	tween tracheal car-
12–14 mm)	glands (= goblet	tilage and in mem-
	cells)	branous walls
		(paries)

Lobar bronchi	Multilayered ciliated	Seromucous bron-	Cartilaginous tunica	At first residual
(diameter:	columnar epithe-	chial glands, pre-	muscularis	hyaline cartilage of
8–12 mm) and	lium with many go-	dominantly in the		irregular appear-
segmental bronchi	blet cells	cartilaginous		ance and organiza-
(diameter:		tunica muscularis		tion, then cartil-
2–6 mm)				age; elastic cartil-
				age in the smaller
				bronchi

Bronchioles	Single-layered cil-	Still sporadic sero-	Tunica muscularis	Absent
(diameter:	iated cuboidal epi-	mucous (mixed)
0.3–0.6 mm)	thelium without go-	glands
	blet cells

Respiratory bron-	Single-layered cu-	Absent	Tunica muscularis	Absent
chioles (diameter:	boidal epithelium
0.25–0.5 mm)	without cilia; no go-
	blet cells

Alveolar ductules	Single-layered	Absent	Smooth muscle	Absent
(diameter:	cuboidal epithelium		cells in the basal rings
0.2–0.4 mm)	of gradually		around the
	decreasing		alveolar opening
	height

Alveoli	Single-layered squa-	Absent	Absent (only elastic	Absent
	mous epithelium; al-		and reticular struc-
	veolar epithelial		tures remain)
	cells type I and II, al-
	veolar phagocytes

Tables

511

Tables

512

Table 13 Lymphatic organs: distinctive morphological features

Organ	Capsule and con-	Parenchyma	Characteristic vessels	Other features
	nective tissue
	septa
Lymph nodes	Well developed,	Lymphoreticular, com-	Afferent vessel, mar-	Surrounded by loosely
	clearly visible	pact cortex with lymph	ginal sinus, interme-	organized connective
	trabeculae	follicles, lighter me-	diary sinus, medullary	tissue and adipose
		dulla with medullary	sinus, efferent vessel;	tissue; lymph vessels
		cords	in the lumina of all	with valves often exist
			sinuses: a bow-net	in the vicinity; no sur-
			(weir) system of re-	face epithelium
			ticular fibers and re-
			ticular cells, no blood
			cells

Spleen	Very well de-	Lymph nodes and lym-	Characteristic blood	Single-layered flat peri-
	veloped, strong,	phoreticular sheaths	vessels (laminar	toneal epithelium
	strong trabeculae	around the central ar-	vessels, central artery,	forms a sheath around
		tery = white pulp. The	penicillary arteriolae,	the capsule
		red pulp is not part of	splenic sinus with
		the lymphatic system	gaps, muscle-free
			pulp and laminar
			veins); blood cells in
			the lumen of the
			splenic sinus

Tonsils
Palatine ton-	Well-developed,	Lymphoreticular nodes	–
sils	weak trabeculae	(lymph follicles) sur-
		round 10–15 bran-
		ched, narrow epithelial
		invaginations (fossulae
		tonsillares with tonsil-
		lar crypts)
Pharyngeal	Not well-de-	Lymphoreticular nodes	–
tonsils	veloped, thin	(lymph follicles) sur-
		round wide epithelial
		folds and epithelial in-
		vaginations
Lingual ton-	Not well de-	Lymphoreticular nodes	–
sils	veloped, thin, no	(lymph follicles) sur-
(= all lingual	trabeculae	round solitary epithe-
follicles)		lial pits

Multilayered nonkeratinizing squamous epithelium, interspersed with lymphocytes inside the invaginations and crypts; in the vicinity, but outside the capsule, there are small mucous glands, which normally do not end in the epithelial invaginations; bulging shape, multilayered ciliated epithelium with goblet cells; mixed (seromucous) glands end in the epithelial invaginations; multilayered nonkeratinizing squamous epithelium; mucous glands end in the epithelial invaginations; basic lingual tissue, striated lingual musculature

Thymus	Well-developed,	Lymphoepithelial; no	–	Involution after pub-
	partitioning into	lymph follicles; denser		erty; adipose tissue
	lobes by connec-	cortex, more loosely		gradually replaces the
	tive tissue septa	organized medulla		parenchyma; in senes-
		with interspersed lym-		cence: adipose tissue
		phocytes; epithelial		with parenchyma islets
		Hassall bodies in the
		medulla

Table 14 Hollow organs: differential diagnosis of hollow organs (ducts) with stellate or round openings

Organ	Epithelium	Glands	Musculature	Special features
Eso-	Multilayered nonkerati-	Branched, tubuLamina muscularis muco-		Layered structure like in
phagus	nizing squamous epi-	lar mucous	sae; tunica muscularis,	the entire intestinal tract;
	thelium	glands (esoph-	defined by inner circular	clearly defined lamina
		ageal glands) in	muscle fibers and outer lon-	muscularis mucosae
		the submucosal	gitudinal muscle fibers; stri-
		tissue	ated muscle fibers in the
			upper third

Ureter	Transitional epithelium	None	Strong tunica muscularis,	Muscle layers often not
	(urothelium)		three-layered: inner and	clearly defined, less com-
			outer (weak) longitudinal	pact, copious inter-
			muscle fibers and a medium	spersed connective
			layer of (strong) circular	tissue
			muscle fibers

Urethra	Female urethra: transi-	Urethral glands	Inner longitudinal and outer	Female urethra: muscular
	tional epithelium, multi-	and urethral la-	circular muscle fibers, in	stratum spongiosum ure-
	layered nonkeratinizing	cunae; endothesome cases, striated muscle		thrae.
	squamous epithelium	lial mucous	fibers of the urethral pelvis	Male urethra: tunica
	toward the vestibular	glands and go-		muscularis connects with
	opening.	blet cells		the smooth musculature
	Male urethra: transi-			of the prostate gland;
	tional epithelium up to			wide, muscle-free veins
	the pars prostatica,			of the lamina propria
	then multilayered, cu-
	boidal epithelium; fossa
	navicularis with multi-
	layered nonkeratinizing
	squamous epithelium

Vas	Two-layered columnar	None	Tunica muscularis with a	Lamina propria is rich in
deferens	epithelium with stereo-		diameter of 1.0–1.5 mm,	elastic fibers; often, the
	cilia		particularly thick; three-	entire spermatic cord is
			layered helical structure:	also sectioned
			inner and outer longitudinal
			muscle layers, intermediary
			circular muscle layer

Oviduct	Single-layered columnar	None	Tunica muscularis is rela-	Elaborate folding of the
	epithelium with brush		tively thin, double-layered,	mucous membrane in
	border and goblet cells		outer longitudinal muscle	the ampulla; strong
			fibers, stronger inner circu-	muscle fibers in the is-
			lar layer; often also a longi-	thmus, only flat residual
			tudinal inner layer of muscle	mucous membrane folds
			fibers (cells)

Vermi-	Single-layered columnar	Crypts	Thin lamina muscularis mu-	Many lymph follicles in
form ap- epithelium with brush			cosae; tunica muscularis	the lamina propria push
pendix	border and goblet cells		with inner circular muscle	through the lamina mus-
			layer and outer longitudinal	cularis mucosae; serosa
			muscle fibers	and meso-appendix

Gallblad-	Single-layered columnar	Goblet cells and	Tunica muscularis is more	Irregularly shaped mu-
der	epithelium with short	mucous glands	loosely structured, web-like	cous membrane folds,
	rod-like microvilli and	only after stimu-		formation of Luschka’s
	junctional complexes	lation by inflam-		ducts
	(terminal bars)	matory pro-
		cesses

Bile duct	Single-layered columnar	Tubular coiled	Muscle cells arranged in a	Strong musculature at
	epithelium	glands	braid-like configuration,	the opening clearance to
			mostly circular muscles	the second part of duo-
				denum, sphincter of
				Oddi

Tables

513

Table 15 Alveolar glands and “gland-like” organs: differential diagnosis

Organ	Formation of lobes	Acini – mucous membrane –
		epithelium – duct systems

Prostate gland	Marginally developed; outer
	periurethral zone, inner and
	outer zone

30–50 tubuloalveolar glands with wide lumina; raised epithelial areas and invaginations; cuboidal epithelium as well as single or double-layered columnar epithelium; 15–30 secretory ducts end on the seminal colliculus and in the surrounding urethra, prostatic ducts

Efferent ductules of	8–12 efferent ductules form a
the testis	conical lobe

Raised surface areas and pits create an undulating surface in the lumen; cuboidal epithelium in the base of the pits, multilayered columnar epithelium with kinocilia and/or microvilli (brush border) on the upper raised portions; the efferent ductules wind strongly and end in the vas deferens

Seminal vesicle	Only apparently partitioned	About 15 cm long coiled duct; bizarre relief of sur-
	into lobes	face folds with primary, secondary and tertiary folds
		and invaginations (alveoli) with wide lumina; single or
		double-layered columnar epithelium; secretory duct

Bulbourethral	Barely expressed	Branched tubular glands with invaginations, sometimes
glands(Cowper’s		alveolar acini; single-layered cuboidal to columnar epi-
glands)		thelium, secretory duct

Mammary gland	Very clearly discernible	15–20 single branched tubuloalveolar glands, alveolar
		acini of different size, epithelial cells of different height
		with lipid droplets; apical protrusions (apocrine extru-
		sion); always visible: sections of large lactiferous ducts

Ampulla of the oviduct	–	Tunica mucosa with many folds, primary, secondary
		and tertiary folds; narrow slit-shaped lumina; single-
		layered columnar epithelium with secretory cells and
		ciliated cells

Thyroid gland	Clearly discernible	Follicles (= “alveolar acini”), variable in shape and size
		(50–500 μm); single-layered epithelium, height varies
		with functional state; no secretory ducts, because it is
		an endocrine gland

Embryonic lung	Clearly discernible	Acini often appear in the form of branched epithelial
		tubes or not quite developed alveoli; cuboidal epithe-
		lium; clearly discernible system of canals

Tables

514

Musculature	Special morphological characteristics

Many smooth muscle cells in the interstitial connective tissue (“fibromuscular stroma”)

Capsule with smooth muscle cells, wide subcapsular venous plexuses; occasionally prostate stones in the gland chambers; elastic and collagenous fibers in the stroma, ganglia cells

Smooth muscle cells in circular arrangement in the	Connective tissue lamina propria is cell-rich but small
lamina propria and outside it

Strong wall made of a meshwork of smooth muscle cells (= tunica muscularis)

Tunica adventitia becomes dense and forms a capsule on the surface

Gland tubules surrounded by smooth muscle cells;	Noticeably light gland cells, clearly defined cell borders
interspersed with striated muscle fibers of the deep
transverse perineal muscle

–	Poorly developed connective tissue; the secretory product in
	the gland lumina can be stained

Tunica muscularis: outer longitudinal layer, more pronounced middle circular layer of smooth muscle cells, inner longitudinal layer (weakly developed)

Clearance with tall branched mucous membrane plicae that almost fill the lumen; outer serosa

–	Follicles filled with colloid; connective tissue capsule, trabecu-
	lae; parafollicular cells (C-cells)

–	Remarkably cell-rich mesenchymal connective tissue

Tables

515

Table 16 Skin areas: differential diagnosis

Skin area

Palms of the hands and soles of the feet

Fingertip

Scalp

Abdominal skin

Skin of the axilla

Skin of the scrotum

Skin of the labium minor

Skin of the outer eyelid

Common characteristics

Multilayered, keratinized squamous epithelium (epidermis), which is layered onto a connective tissue layer (corium) and subcutaneous connective tissue (subcutis)

Lips

Ala nasi

Epidermis

Particularly thick, at 1.5–4.0 mm; thick stratum corneum

Thick; thick stratum corneum

Thin

Moderately thick, pigmented stratum basale

Thin, moderately keratinized epithelium; extensively pigmented stratum basale

thin, transition to nonkeratinized squamous epithelium; sparsely pigmented

Thin, scarcely keratinized, transition to nonkeratinized squamous epithelium of the palpebral tunica conjunctiva

Moderately thick, multilayered keratinized outer squamous epithelium; transitional zone: vermilion border, inner layer: high multilayered nonkeratinizing squamous epithelium

Moderately thick, transition to respiratory epithelium in the nasal vestibule

Tables

516

Hair	Glands	Other features
None	Sweat glands only	Meissner’s corpuscles in the papillary layer,
		Vater-Pacini bodies in the subcutis; a lot of adi-
		pose tissue in the soles of the feet (serve as
		cushions)

None	Sweat glands only	Many Meissner corpuscles in the papillary
		layer, digital glomeruli, nail bed, possibly bone
		tissue of the end phalanx

Terminal hair	Sweat glands, sebaceous glands	Aponeurosis epicranialis

Lanugo hair	Sweat glands, sebaceous glands	Thin corium, thick subcutis with adipose tissue
		(panniculus adiposus)

Many terminal and	Many sweat glands, sebaceous glands	Thick, lipid-rich subcutis
lanugo hairs	and apocrine olfactory glands

Sparse	Sporadic apocrine olfactory glands,	Skin is wrinkled; smooth muscle cells in the re-
	large sebaceous glands	ticular and subcutaneous tissue layers (tunica
		dartos); adipose tissue

None	Sporadic sweat glands and sebaceous
	glands

Diffuse lymphocyte infiltrates in the cutaneous mucous membranes, no subcutis; poor in adipose tissue

Eyelashes	Glands of Meibom (holocrine), Moll	Tarsus, smooth muscle cells of the tarsal
	(apocrine) and Krause (eccrine)	muscle, striated muscles of the elevator
		muscle of the upper lid

Only at the outer	Outer lip: sebaceous glands, sweat
lips	glands; inner lip: seromucous labial
	glands

Vermilion border; unpigmented epithelium, sporadic small sebaceous glands; striated orbicular muscle of the mouth

Outer border, vibrissae in the nasal vestibule

Outer ala nasi: many single sebaceous glands; inner ala nasi: sebaceous glands and apocrine vestibular glands

Hyaline cartilage; striated musculature, especially in the nasal muscle

Tables

517

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