Difference between revisions of "Colon"

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(+Formalin)
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*Semi-quantitate the number of '''diverticula''' – “numerous” if too many to count
 
*Semi-quantitate the number of '''diverticula''' – “numerous” 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.
*Note any obvious mesenterial '''lymph nodes'''
+
*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:  
 
*'''Sections''' to submit for microscopy:  
 
:*2 sections of any perforation(s), one section of any intact diverticulum, any mucosal lesions, any obvious lymph nodes.
 
:*2 sections of any perforation(s), one section of any intact diverticulum, any mucosal lesions, any obvious lymph nodes.

Revision as of 12:42, 27 November 2020

Author: Mikael Häggström [note 1]

Endoscopic biopsies   edit
Mostly:

This article also includes the rectum.

Presentations

Gross processing

More specific grossing is available for presentations above. For larger specimens (not biopsies):

  • Identify segment of colon
  • Measure length and variations in width
  • 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]
  • Semi-quantitate the number of diverticula – “numerous” 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:

  • Colitis, such as by neutrophilic infiltration

Common incidental findings

Microscopy report

Example report in an unremarkable biopsy:

Colonic mucosa, negative for significant histopathologic changes.

Notes

  1. It is acceptable to not mention a subepithelial lymphoid aggregate at all.
  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. Burroughs, S H (2000). "Examination of large intestine resection specimens ". Journal of Clinical Pathology 53 (5): 344–349. doi:10.1136/jcp.53.5.344. ISSN 00219746. 

Image sources