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Gross Examination of Colonic Resection Specimen in Non-Neoplastic Colorectal Diseases

Dr Sampurna Roy MD

 

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Non-Neoplastic Colorectal Diseases:

-Complicated diverticular disease

-Ulcerative colitis

-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

Further reading: Examination of large intestine resection specimens

 

GI Path Online-Home Page

 

 Pathology of Large  Intestine - Home Page

 

 

 

Dr Sampurna Roy  MD

Consultant  Histopathologist (Kolkata - India)


 

 

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