Hyperplasia of lymphoglandular complexes in colon segments in Hirschsprung's disease: a form of diversion colitis.

Abstract

This is a study of the size and number of lymphoglandular complexes (LGDs) in the resected segment of aganglionic left colon of 20 children (mean age 26 months) obtained several months to years after being defunctionalized by proximal colostomy, compared with 5 controls (mean age 20 months). All the resected aganglionic segments had a nodular mucosa. The number of LGCs/mm of muscularis mucosae was 0.58 +/- 0.2; in controls the number was 0.24 +/- 0.12 (P less than .0025). The mean size of LGCs in aganglionic colon was 1.23 +/- 0.27 mm, and in controls it was 0.57 +/- 0.21 (P less than .0005). Because LGCs have been related to antigen processing, hyperplasia of LGCs in defunctionalized colonic segments of Hirschsprung's disease may represent a reaction to stagnant contents. Its combination with cryptitis (present in six cases) may represent a form of diversion colitis, a condition recognized in adults in bypassed colonic segments after surgical diversion of the fecal stream.