The typical findings of Hirschsprung’s disease include absence of ganglion cells. What other stain can help support the diagnosis, and what is the ideal site of biopsy?
- Acetylcholinesterase stain highlights the proliferation of thickened nerve fibers in the lamina propria and muscularis mucosae.
- This stain is done on the frozen tissue.
- So, ideally, two biopsy samples are sent—one in formalin and another fresh for freezing.
- The site of biopsy is at least 2 cm above the dentate line.
- The lower rectum (adjacent to dentate line) is physiologically hypoganglionic.
- Also, submucosa should be included in the biopsy samples to assess nerves in both the lamina propria and muscularis mucosae.
