[Histological study of the tracheal adventitia, perichondrium and annular ligament]

The trachea begins at the lower border of the cricoid cartilage and passes down to bifurcate into the left and right mainstem bronchi. The presence of tracheal invasion is crucial factor influencing the prognosis for patients with cancers of the thyroid gland, hypopharynx, esophagus, etc. In order to understand the manner of invasion of the above tumors, precise knowledge of the normal tracheal structure is indispensable. This study was undertaken to clarify the normal microscopic structure of the trachea. Five normal tracheal specimens obtained at surgery were examined histologically and immunohistochemically. The loose connective tissue around the trachea, known as adventitia, was divided into a loose outer and a dense inner layer by hematoxylin and eosin (HE) staining. This two-layer pattern was clearly seen near the annular ligament but was obscured away from it. The connective tissue of the inner layer ran obliquely to joint the connective tissue of the annular ligament and ended in the submucosal layer. This arrangement of connective fibers seems to play a role in allowing the trachea to stretch and bend. Tracheal cartilage is covered with a dense fibrous membrane known as the perichoundrium. Between the superficial fibrous membrane and mature cartilage cells lies zone of immature cartilage made up of oval or spindle cells, and the inclusion of this zone in the perichondrium has long been a subject of controversy. In our study, the zone was homogeneously stained red by the elastica van Gieson's stain and was clearly distinguished from other structures. Immunohistochemical staining revealed a wide distribution of type I and type III collagen on the fibrous membrane and the zone of immature cartilage cells, while mature cartilage cells did not show such collagen. Based on these findings, we conclude that the zone of immature cartilage cells belongs to the periochondrium, which thus contains two layers, an outer fibrous layer and an inner transitional layer of immature cartilage cells. Our conclusions are as follows: 1. Tracheal adventitia is divided into two layers, an outer loose and an inner dense fibrous layer. 2. Tracheal perichondrium also consists of two layers, an outer fibrous layer and an inner transitional layer. 3. The fibrous bundle originating from the adventitia joins the connective tissue of the annular ligament, probably in order to allow the trachea to stretch and bend.