Colon: Difference between revisions
Jump to navigation
Jump to search
→Gross processing: +Fat |
→Gross processing: +Diverticula |
||
| Line 25: | Line 25: | ||
*'''Open''' longitudinally | *'''Open''' longitudinally | ||
*If the specimen is not fixed already, put it in '''formalin''', preferably for a total of 48 hours.<ref name="Burroughs2000">{{cite journal|last1=Burroughs|first1=S H|title=Examination of large intestine resection specimens|journal=Journal of Clinical Pathology|volume=53|issue=5|year=2000|pages=344–349|issn=00219746|doi=10.1136/jcp.53.5.344}}</ref> Section attached fatty tissue for better fixation. | *If the specimen is not fixed already, put it in '''formalin''', preferably for a total of 48 hours.<ref name="Burroughs2000">{{cite journal|last1=Burroughs|first1=S H|title=Examination of large intestine resection specimens|journal=Journal of Clinical Pathology|volume=53|issue=5|year=2000|pages=344–349|issn=00219746|doi=10.1136/jcp.53.5.344}}</ref> Section attached fatty tissue for better fixation. | ||
*Semi-quantitate the number of '''diverticula''' – “numerous” if too many to count | [[File:Gross pathology of diverticulosis.jpg|thumb|220px|Multiple diverticula.]] | ||
*Semi-quantitate the number of '''diverticula''' – “numerous” or "multiple" if too many to count | |||
*Look for for any '''mucosal lesions'''. Note any evidence of inflammation, hemorrhage, abscess, perforation or fistula | *Look for for any '''mucosal lesions'''. Note any evidence of inflammation, hemorrhage, abscess, perforation or fistula | ||
*Note the '''thickness''' of the wall. | *Note the '''thickness''' of the wall. | ||
Revision as of 19:07, 18 May 2021
Author:
Mikael Häggström [note 1]
| Mostly: |
This article also includes the rectum.
Presentations
- Colorectal polyp
- Colon ischemia
- Colon for diverticulitis
- Intestine with tumor
- Colitis
- Hemorrhoids
- Stoma and "donuts"
Gross processing
More specific grossing is available for presentations above. For larger specimens (not biopsies):
- Identify segment of colon if possible.
- Measure length, average width and any significant variations thereof.
- Optionally, measure the mesentery.
- Inspect the serosa- look for any perforations, adhesions, fistulas and exudate
- If perforation is present, try to probe it from the serosal surface
- Open longitudinally
- If the specimen is not fixed already, put it in formalin, preferably for a total of 48 hours.[1] Section attached fatty tissue for better fixation.
- Semi-quantitate the number of diverticula – “numerous” or "multiple" if too many to count
- Look for for any mucosal lesions. Note any evidence of inflammation, hemorrhage, abscess, perforation or fistula
- Note the thickness of the wall.
- If a cecal segment does not show an appendix, look in the history for a past appendectomy. If not, put more effort into finding it before reporting it as not found.
- Note any obvious mesenterial lymph nodes.
- Sections to submit for microscopy:
- 2 sections of any perforation(s), one section of any intact diverticulum, any mucosal lesions, any obvious lymph nodes.
Microscopic evaluation
Screening
In a general screening, look for:
-
Hyperplasia and/or atypia (colorectal polyp with tubular adenoma pictured)
- Colitis, such as by neutrophilic infiltration
Common incidental findings
-
Melanosis coli, lipofuscin-containing macrophages
-
Subepithelial lymphoid aggregate, nonspecific, and generally reported as such.[notes 1]
.jpg){kind=link}
![Subepithelial lymphoid aggregate, nonspecific, and generally reported as such.[notes 1]](/index.php?title=Special:Upload&wpDestFile=Histology_of_subepithelial_lymphoid_aggregate_of_the_colon.jpg){kind=link}
Microscopy report
Example report in an unremarkable biopsy:
| (Colon, biopsy:) Colonic mucosa without significant histopathologic changes. |
Notes
- ↑ It is acceptable to not mention a subepithelial lymphoid aggregate at all.
- ↑ For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Patholines:Authorship for details.
Main page
References
Image sources