Unusual histological appearances of barium sulphate--a case report with scanning electron microscopy and energy dispersive x ray analysis

Multiple birefringent rhomboidal crystals seen on histological examination of a resected oesophagus were subsequently found to contain elemental barium and sulphur on energy dispersive x ray ( EDX ) analysis. Scanning electron microscopy and EDX analysis of readily available commercial barium sulphate suspensions suggested that the two forms of barium sulphate previously described in tissue sections may be a result of the method of preparation of the commercial suspension used. With increased use of barium sulphate prepared by crushing the natural compound, birefringent rhomboidal crystals should be found with increasing frequency in endoscopic biopsy samples and resected specimens.