Slide 1

This is an endoscopic view of esophageal varices, which appear as tortuous, dilated, blue veins running along the long axis of the esophagus.

Slide 2

This is a photograph of the actual histologic slide in your class set.  Note the markedly dilated veins in the submucosa and in the muscularis propria of the esophagus.

Slide 3
These dilated varices often cause pressure atrophy and ulceration of the overlying mucosa, as has happened in this case.  The subsequent inflammation of the submucosa causes erosion of the thin wall of the varices with subsequent rupture.  The large varix noted by the arrow communicates directly with the lumen and has probably ruptured in the past.  It is now thrombosed.

Shows thrombosis of a large submucosal varix.  Note the ulceration of the overlying mucosa (arrow) and inflammation of the submucosal stroma.