Barium Sulfate, Esophageal Inclusions
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.
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.
Barium granulomas, when large enough, produce brownish-green masses associated with fibrosis.
Fine gray/greenish non-refringent granules (PAS negative)
Larger birefringent rhomboid crystals
Barium is located in the cytoplasm of macrophages and extracellular...
References and Further Reading
- Morson, B. C., & Dawson, I. M. P. (2003). Gastrointestinal pathology (4th ed., p. 86). Malden: Blackwell.Google Scholar