Synonyms
Barium granuloma
Definition
Barium sulfate is an inorganic compound (BaSO4) used since the early 1900s in colloidal suspension as a contrast medium in the gastrointestinal tract. Extravasation of barium into the wall of the esophagus through an injury in the mucosa (whatever the cause) provokes a reaction against it, as a granulation tissue or more commonly as a granulomatous reaction.
Clinical Features
It is a very rare complication and usually an incidental finding in biopsies or resection specimens for other reasons, but can present as a polypoid or ulcerative lesion.
Macroscopy
Barium granulomas, when large enough, produce brownish-green masses associated with fibrosis.
Microscopy
Barium sulfate can be seen in histological sections in two ways, depending on the method the commercial suspensions are prepared:
Fine gray/greenish non-refringent granules (PAS negative)
Larger birefringent rhomboid crystals
Barium is located in the cytoplasm of macrophages and extracellular...
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Levison, D. A., Crocker, P. R., Smith, A., Blackshaw, A. J., & Bartram, C. I. (1984). Varied light and scanning electron microscopic appearances of barium sulphate in smears and histological sections. Journal of Clinical Pathology, 37(5), 481–487.
Morson, B. C., & Dawson, I. M. P. (2003). Gastrointestinal pathology (4th ed., p. 86). Malden: Blackwell.
Womack, C. (1984). Unusual histological appearances of barium sulphate – A case report with scanning electron microscopy and energy dispersive X ray analysis. Journal of Clinical Pathology, 37(5), 488–493.
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© 2017 Springer International Publishing
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de Oliveira, M.F. (2017). Barium Sulfate, Esophageal Inclusions. In: Carneiro, F., Chaves, P., Ensari, A. (eds) Pathology of the Gastrointestinal Tract. Encyclopedia of Pathology. Springer, Cham. https://doi.org/10.1007/978-3-319-40560-5_1563
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DOI: https://doi.org/10.1007/978-3-319-40560-5_1563
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