Virchows Archiv

, Volume 474, Issue 3, pp 395–400 | Cite as

Histological characteristics of eosinophilic myenteric ganglionitis: an under-recognised cause of chronic intestinal pseudo-obstruction

  • Yoichi Akazawa
  • Takuo HayashiEmail author
  • Tsuyoshi Saito
  • Koichiro Niwa
  • Hirohiko Kamiyama
  • Noriko Sasahara
  • Kazuhiro Sakamoto
  • Akihito Nagahara
  • Takashi YaoEmail author
Brief Reports


Eosinophilic myenteric ganglionitis (EMG) is characterised by eosinophilic infiltration of the myenteric plexus. EMG has been rarely reported as a cause of chronic intestinal pseudo-obstruction (CIPO), and its histopathological features are not fully elucidated. We analysed seven patients with CIPO. Three of them were diagnosed with EMG and four patients were categorised as non-EMG. Clinicopathological features were similar in both groups. These features included subtle to mild lymphocytic infiltration at the myenteric ganglia/muscularis propria, loss of myenteric ganglions and interstitial cells of Cajal (ICC), and no significant findings in the mucosa. The exceptions were moderate to severe degree of eosinophilic infiltration at the myenteric ganglia/muscularis propria in EMG. Functional gastrointestinal obstruction may be associated with inflammatory cell infiltration at the myenteric ganglia/muscularis propria, leading to subsequent hypoganglionosis and deficiency of ICC in EMG. Pathologists and clinicians should be aware of this distinction during differential diagnosis of patients with CIPO.


Eosinophilic myenteric ganglionitis Chronic intestinal pseudo-obstruction Auerbach plexus Myenteric ganglia Interstitial cells of Cajal α-Synuclein 



The authors thank Katsuya Miyahara and Keiko Mitani for their technical assistance and advice.

Author’s contributions

Yoichi Akazawa, Takuo Hayashi, and Tsuyoshi Saito conceived and designed the study and wrote, edited, and reviewed the manuscript. Koichiro Niwa and Hirohiko Kamiyama provided and gave patient’s clinical information. Noriko Sasahara provided histological and immunohistochemical technical assistance. All authors gave final approval for publication. Takuo Hayashi, Kazuhiro Sakamoto, Akihito Nagahara, and Takashi Yao take full responsibility for the work as a whole, including the study design, access to data, and the decision to submit and publish the manuscript.


This study was supported by Grant-in-Aid for the Japan Society for the Promotion of Science (JSPS) KAKENHI (Grant Number 17K08704 to TY).

Compliance with ethical standards

The information contained in, and preparation of, this manuscript complies with the journal’s ethical standards.

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Yoichi Akazawa
    • 1
    • 2
  • Takuo Hayashi
    • 1
    Email author
  • Tsuyoshi Saito
    • 1
  • Koichiro Niwa
    • 3
  • Hirohiko Kamiyama
    • 3
  • Noriko Sasahara
    • 1
  • Kazuhiro Sakamoto
    • 3
  • Akihito Nagahara
    • 2
  • Takashi Yao
    • 1
    Email author
  1. 1.Department of Human Pathology, School of MedicineJuntendo UniversityTokyoJapan
  2. 2.Department of Gastroenterology, School of MedicineJuntendo UniversityTokyoJapan
  3. 3.Department of Coloproctological Surgery, School of MedicineJuntendo UniversityTokyoJapan

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