Gross examination of colorectal specimen in non-neoplastic colorectal diseases

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Adult Respiratory Distress Syndrome

Dr Sampurna Roy MD

http://www.histopathology-india.net/LargeIntestinePath.htm

April 2007

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NORMAL HISTOLOGY OF ESOPHAGUS

AN APPROACH TO THE REPORTING OF ESOPHAGEAL BIOPSIES

BARRETT'S ESOPHAGUS (INTESTINAL METAPLASIA DYSPLASIA & ADENOCARCINOMA)

BENIGN TUMOURS AND TUMOUR - LIKE CONDITIONS OF ESOPHAGUS

1. SQUAMOUS PAPILLOMA OF THE ESOPHAGUS

2. INFLAMMATORY FIBROID POLYP OF THE ESOPHAGUS

3. LEIOMYOMA OF THE ESOPHAGUS

4. GRANULAR CELL TUMOUR OF THE ESOPHAGUS

5. ESOPHAGEAL CYSTS

6. GLYCOGENIC ACANTHOSIS

REPORTING OF ESOPHAGEAL RESECTION SPECIMENS

SQUAMOUS EPITHELIAL DYSPLASIA INCLUDING SQUAMOUS CELL CARCINOMA IN-SITU OF THE ESOPHAGUS

SMALL CELL CARCINOMA OF THE ESOPHAGUS

Assessment of the Intestinal abnormalities - lumen, surface epithelium and the subepithelial zone : click

Assessment of the Intestinal abnormalities :crypt density, architecture and epithelium : click

Assessment of abnormalities :changes in the lamina propria, muscularis mucosae and submucosa ): click

Normal Histology of the Large Intestine

Interpretation of Large Intestinal Biopsies

Microscopic/collagenous colitis

Pseudomembranous colitis

Pathology of Amebic Colitis

Eosinophilic Gastroenteritis

Non-neoplastic Colorectal diseases:
Complicated diverticular disease
Ulcerative colitis CLICK
Crohn's disease
Ischaemic colitis
Volvulus
Angiodysplasia
Motility disorders
Radiation colitis

Note: Specimen dissection and block selection depends on the specific pathology.

Blocks:
Sections are taken at each 10cm distance from the proximal to distal resection margins.
Sampling of any focal lesion.
Sections of the resection margins or doughnuts (in ulcerative colitis to rule out dysplasia).
Any stricture should be sampled to rule out malignancy.
Lymphnodes should be sampled (no need to embed all nodes)

Handling and preservation of freshly received specimen in the lab:

- The pathologist should examine the serosal surface of the unopened fresh specimen (look for fistula or perforation)
- Specimen is opened throughout its length along the antimesenteric wall (including any stricture).
- Faeces blood and mucus removed by gentle washing in cold running water.
- Resection specimen pinned to cork board and fixed for atleast 48 hrs.
- Specimen may be unpinned and floated free in fixative after initial 24 hrs.

Gross description of the specimen:
Description should include the nature of specimen (extent of surgical resection).
Record the nature, extent & distribution of changes in non-neoplastic lesions.

Record the following features:

-Serosa - fibrin, pus, fibrosis, adherence of mesentery
-Distribution of serosal fat wrapping
-Mural thickening
-Severe dilatation (toxic megacolon)
-Stricture formation
-Ulcers (linear or transverse)
-Mucosal cobblestoning
-Perforation
-Pseudopolyps
-Hemorrhage
-Fissures
-Any suspicious neoplastic lesion

Visit: Gross examination of polypectomey specimens