Histology of Nasopharynx

&
Pleura
Department of Histology FK USU
LokDonLub-ERDS
2013
 NASOPHARYNX
The pharynx has 3
functionally & structurally
dispersed subparts:
nasopharynx, oropharynx,
& hypopharynx

The nasopharynx: portion of

the pharynx that lies above
the soft palate

It has anterior, posterior, &

lateral walls This sagittal section delineates the
boundaries of the nasopharynx,
oropharynx, & hypopharynx
 NASOPHARYNX
The roof is composed of mucosa overlying the basal
portions of the sphenoid & occipital bones

The lateral & posterior walls composed of the superior

constrictor muscles & the pharyngobasilar fascia

The floor of the anterior portion of the nasopharynx is the

soft palate (the only truly mobile portion of the
nasopharynx)

The soft palate can be moved posteriorly & superiorly to

completely separate the nasal & oral segments
Important for proper speech & to keep food & water out
of the nasal region during eating & drinking
 NASOPHARYNX
The most important gross features of nasopharynx
are the pharyngeal tonsil, pharyngeal recess, &
the eustachian tube openings:
The pharyngeal tonsil, or adenoids: a prominent,
convoluted mass in the roof of the nasopharynx in
children. (It typically atrophies in adults.)
The pharyngeal recess, or Rosenmller's fossa: a
mucosal-lined depression in the posterolateral portion
of the nasopharynx
The ostium of the eustachian tube: Located in the
lateral wall, anterior to the recess, surrounded on its
superior & posterior aspects by mucosa-covered
cartilage, the tubal torus, from the eustachian tube wall
NASOPHARYNX: MICROSCOPIC ANATOMY
The nasopharyngeal mucosa in the adult has a
surface area of about 50 cm2
60% lined by stratified squamous epithelium:
predominantly lines the lower portion of the anterior &
posterior nasopharyngeal walls, as well as the anterior
half of the lateral walls
40% is covered by respiratory-type, columnar
epithelium: predominantly carpets the region of the
posterior nares (choanae) & the roof of the posterior
wall
The remainder of the nasopharynx, including the
posterior lateral walls & the middle-third of the
posterior wall, has alternating islands of squamous &
respiratory epithelium
NASOPHARYNX: MICROSCOPIC ANATOMY
Lamina propria (submucosal) nasopharynx, consist of:
Numerous submucosal seromucinous glands, produce
predominantly mucin
The pharyngeal tonsil
Collections of lymphoid follicles:
Component of Waldeyers ring of lymphoid tissue protecting the
entry portals of the respiratory and gastro-intestinal systems.
Particularly abundant in the rim of the eustachian tube opening
(Gerlach's, or tubal, tonsil)
Under mucosa of the lateral & posterior walls of the nasopharynx, as
well as on the nasopharyngeal surface of the soft palate

A submucosal follicular lymphoid infiltrate is normal in

nasopharyngeal biopsies & should not be
overinterpreted as a pathologic inflammatory process
 Nasopharynx

RE Respiratory
Epithelium
L lymphoid
tissue
Submucosal lymphoid aggregates are present normally throughout
the nasopharynx & should not be overly interpreted as severe
chronic inflammation
 PLEURA
The lung's outer surface & the internal wall of the
thoracic cavity covered by a serous membrane called the
pleura:
The visceral pleura: the membrane attached to lung tissue
The parietal pleura: the membrane lining the thoracic walls

The two layers are continuous at the hilum & both

composed of:
Simple squamous mesothelial cells
A thin connective tissue layer containing collagen & elastic
fibers

The elastic fibers of the visceral pleura are continuous

with those of the pulmonary parenchyma
 PLEURA contd
The elastic tissue is often not a single layer, & several layers
may be apparent

Lymphatic vessels that are continuous with those in the

interlobular septa are also identifiable in the pleura

In pathologic conditions the elastic tissue may greatly increase

Elastic tissue stains are useful in assessing whether a given

pathologic process, such as carcinoma, has transgressed the
visceral pleura

Pleural assessment is important in separating T1 carcinomas

from T2 carcinomas; the latter invade the visceral pleura
 PLEURA contd
The narrow pleural cavity between the parietal &
visceral layers is entirely lined with mesothelial cells
that normally produce a thin film of serous fluid acts as
a lubricant during respiratory movements

In certain pathologic states, the pleural cavity may

contain liquid or air

The serosa of the pleural cavity (like the walls of the

peritoneal & pericardial cavities) is quite permeable to
water & fluid exuded from blood plasma commonly
accumulates (as a pleural effusion) in this cavity under
abnormal conditions
 The pleura are
serous membranes
(serosa) associated
with each lung &
thoracic cavity.

Diagram illustrates
the parietal pleura
lining the inner
surface of the
thoracic cavity & the
visceral pleura
covering the outer
surface of the lung.

Between these layers

is the narrow space
of the pleural cavity
 Visceral pleura

F fibrous tissue
L lymphatic vessel
M mesothelial cells
P visceral pleura
S fibrous septum
Both pleura layers are similar histogically & consist of a simple squamous mesothelium
(M) on a thin layer of connective tissue, as shown here for visceral pleura covering
alveoli (A). The connective tissue is rich in both collagen & elastic fibers & contains
both blood vessels (V) & lymphatics (L). X140
 Pleural elastic tissue (elastic stains).
The pleura contains an elastic tissue membrane, which may
appear as a single thin layer of elastic tissue (A) or as a richer
network with occasional elastic fibers distributed through the
thickness of the visceral pleura (B.). The field illustrated in (A)
shows a normal lymphatic at the juncture between an
interlobular septum and the visceral pleura
 THE MESOTHELIAL CELLS
Stretchable, may appear flat, cuboidal, or columnar:
Cuboidal or columnar cells associated with a substructure that is
loose or fatty, as in the pleural recesses, or indicate that the cells are
metabolically active
Flattened cells usually represent stretched quiescent cells on the
visceral surface or cover a very rigid substructure such as a rib

Mesothelial cells characterized ultrastructurally by an

abundance of elongated bushy microvilli aids in the
ultrastructural identification of mesotheliomas

The microvilli trap hyaluronic acid, which acts as a lubricant to

lessen the friction between the moving lung & the chest wall

The cytoplasm is rich in pinocytotic vesicles, mitochondria, &

other organelles and prekeratin fibrils
 THE MESOTHELIAL CELLS contd
Its the function of the mesothelial cells to
regulate the amount & composition of the thin
fluid. Therefore, the mesothelial cells are osmotic
pumps provided with pinocytotic vesicles and
microvilli on both flat surfaces.

Under abnormal circumstances, when the amount

of fluid in the body cavity is increased (a condition
known as effusion), the two opposing layers of
the mesothelium separate, & the mesothelial cells
may form a multilayered epithelium composed
of larger, cuboidal cells
 Diagrammatic representation of mesothelial sacs, using the pleural
cavity as example. The cavity is actually a potential space between the
two layers of pleura that enclose the lung (A). The circled area is shown
in detail in a histologic cross section (B) and as a sheet of mesothelial
cells in a cytologic preparation (C).
 PLEURA contd
In the resting condition, the different layers of the pleura
may be inconspicuous & the mesothelial cells are only
about 1 m thick

However, these cells are extremely reactive to any type of

injury & frequently undergo hypertrophy & hyperplasia to
produce a much thicker mesothelial cell layer with a
significantly increased number of mesothelial cells

The layers of parietal pleura are not as distinct as in the

visceral pleura

The landmark that may be used to identify the parietal

pleura is the fatty tissue between the skeletal muscle of the
chest wall & the connectiveelastic tissue of the parietal
pleura
In resting state, layers of pleura are rather inconspicuous.
Note flattened appearance of mesothelial lining cells
(arrows).
 Very slight irritation causes mesothelial cells to
undergo hypertrophy and hyperplasia. Cuboidal cells with
enlarged nuclei produce a thickened serosal layer.
Scanning electron micrographs of mesothelial
lining of pleura show extensive microvillous
surface.
 CYTOLOGY EVALUATION OF MESOTHELIAL CELLS
In effusions, the mesothelial cells desquamate from the surface of the lining
of the body cavity & accumulate or even proliferate in the body fluids. Free-
floating mesothelial cells in fluids appear singly, in doublets, or in clusters of
variable sizes & configuration

Upon removal from one of the body cavities, the cuboidal mesothelial cells
may form sheets or clusters, in which the adjacent, flattened surfaces of the
cells are separated from each other by clear gaps (windows) filled by
microvilli

When these cells appear singly, usually spherical & measure about 20 m in
diameter

The perinuclear portion of the cytoplasm of mesothelial cells usually denser

than the periphery because of an accumulation of cytoplasmic organelles &
filaments in the perinuclear location

The clear or faintly granular nuclei of mesothelial cells are usually spherical,
measuring about 8 m in diameter. Occasionally, tiny nucleoli can be
observed
 Mesothelial cells and macrophages in pleural fluid in the absence of cancer.
A. The mesothelial cells & the macrophages are cells of approx. equal size. The macrophages can
be identified because of their phagocytic activity. B,C. Two mesothelial cells showing a
window. Note the spherical nuclei and tiny nucleoli. Barr bodies are present (arrow). D. High
magnification to show a mitotic figure in presumably normal mesothelial cells.
 Clusters of benign mesothelial cells.
A. Mesothelial cells forming a small sheet and a small gland-like
structure. Note that the outer part of the cytoplasm is lighter
than the inner part (high magnification).
B. Large sheet of mesothelial cells from the buffy coat of an
effusion. Note that, in the center of the cluster, the cells form a
monolayer