This article also includes the rectum.
- Colorectal polyp
- Colon ischemia
- Colon for diverticulitis
- Intestine with tumor
- Stoma and "donuts"
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. 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 mesenteric lymph nodes. Further information: 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.
In a general screening, look for:
- Colitis, such as by neutrophilic infiltration
Common incidental findings
Subepithelial lymphoid aggregate, nonspecific, and generally reported as such.[notes 2]
Example report in an unremarkable biopsy:
Colonic mucosa without significant histopathologic changes.
In follow-ups of inflammatory bowel disease (IBD), add "Negative for colitis or dysplasia" if true.