Hemorrhoids

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Author: Mikael Häggström [note 1]

Gross pathology of hemorrhoids, showing engorged blood vessels.

Fixation

Generally 10% neutral buffered formalin.

Comprehensiveness

On this resource, the following formatting is used for comprehensiveness:

  • Minimal depth
  • (Moderate depth)
  • ((Comprehensive))

Gross processing

Gross report

Example:

((A. Labeled - hemorrhoids. The specimen is received in formalin and consists of)) __ [[number of]] irregular fragment(s) of pink-tan tissue, partially covered by skin and mucosa, measuring __. On sectioning, engorged blood vessels are identified. ((Representative sections are submitted for microscopic examination in one cassette.))

Microscopic evaluation

A hemorrhoid; a dilated vein with an organized thrombus, below benign anal epithelium.
  • Have a brief scroll through the tissue to confirm the diagnosis of hemorrhoids (submucosal vessels with dilation, thick walls and congestion, often thrombosed)[1]
  • Look at the epithelium for any anal intraepithelial neoplasia.

Common findings

Microscopic report

  • Diagnosis of hemorrhoids
  • (Description of thrombi.)
  • (Even benign epithelium, with specification of types seen, that is, anoderm, rectal, or anorectal if both are seen.)
  • ((Any epidermal hyperplasia and/or Pagetoid dyskeratosis.))
Example:
(Anal/Rectal/Anorectal tissue, excision:)
Hemorrhoids (with organizing thrombi, and benign anoderm/rectal mucosa/anorectal mucosa.)

Notes

  1. 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

  1. Elliot Weisenberg, M.D.. Anus & perianal area - Other nonneoplastic - Hemorrhoids. Pathology Outlines. Topic Completed: 1 May 2014. Minor changes: 7 June 2021
  2. . Mammary and Extramammary Paget’s Disease. Palstic Surgery Key (2016-06-11).
  3. Val-Bernal JF, Pinto J (2001). "Pagetoid dyskeratosis is a frequent incidental finding in hemorrhoidal disease. ". Arch Pathol Lab Med 125 (8): 1058-62. doi:10.5858/2001-125-1058-PDIAFI. PMID 11473458. Archived from the original. . 

Image sources