Difference between revisions of "Colon"
Jump to navigation
Jump to search
(→Gross processing: Moved) |
m (→Microscopic evaluation: Bolded) |
||
(13 intermediate revisions by the same user not shown) | |||
Line 3: | Line 3: | ||
|author2= | |author2= | ||
}} | }} | ||
+ | {{Endoscopic biopsies}} | ||
This article also includes the rectum. | This article also includes the rectum. | ||
Line 9: | Line 10: | ||
*[[Colorectal polyp]] | *[[Colorectal polyp]] | ||
*[[Colon ischemia]] | *[[Colon ischemia]] | ||
+ | *[[Colon for diverticulitis]] | ||
*[[Intestine with tumor]] | *[[Intestine with tumor]] | ||
*[[Colitis]] | *[[Colitis]] | ||
Line 16: | Line 18: | ||
==Gross processing== | ==Gross processing== | ||
More specific grossing is available for presentations above. For larger specimens (not biopsies): | More specific grossing is available for presentations above. For larger specimens (not biopsies): | ||
− | *Identify '''segment''' of colon | + | *Identify '''segment''' of colon if possible. |
− | *Measure '''length''' and variations | + | *Measure '''length''', average '''width''' and any significant variations thereof. |
+ | *Optionally, measure the '''mesentery'''. | ||
*Inspect the '''serosa'''- look for any perforations, adhesions, fistulas and exudate | *Inspect the '''serosa'''- look for any perforations, adhesions, fistulas and exudate | ||
:*If perforation is present, try to probe it from the serosal surface | :*If perforation is present, try to probe it from the serosal surface | ||
*'''Open''' longitudinally | *'''Open''' longitudinally | ||
− | *Semi-quantitate the number of '''diverticula''' – “numerous” if too many to count | + | *If the specimen is not fixed already, put it in '''formalin''', preferably for a total of 48 hours.<ref name="Burroughs2000">{{cite journal|last1=Burroughs|first1=S H|title=Examination of large intestine resection specimens|journal=Journal of Clinical Pathology|volume=53|issue=5|year=2000|pages=344–349|issn=00219746|doi=10.1136/jcp.53.5.344}}</ref> Section attached fatty tissue for better fixation. |
+ | [[File:Gross pathology of diverticulosis.jpg|thumb|220px|Multiple diverticula.]] | ||
+ | *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 | *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. |
− | * | + | *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 | + | [[File:Gross pathology of a mesenteric lymph node.jpg|thumb|190px|A mesenteric lymph node.]] |
+ | *Note any obvious mesenteric '''lymph nodes'''. {{Further|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. | ||
Line 35: | Line 41: | ||
File:Tubular adenoma of the colon.jpg|Hyperplasia and/or atypia ([[colorectal polyp]] with [[tubular adenoma]] pictured) | File:Tubular adenoma of the colon.jpg|Hyperplasia and/or atypia ([[colorectal polyp]] with [[tubular adenoma]] pictured) | ||
</gallery> | </gallery> | ||
− | *[[Colitis]], such as by neutrophilic infiltration | + | *'''[[Colitis]]''', such as by neutrophilic infiltration |
===Common incidental findings=== | ===Common incidental findings=== | ||
<gallery mode=packed> | <gallery mode=packed> | ||
File:Melanosis coli (4130655629).jpg|'''Melanosis coli''', lipofuscin-containing macrophages | File:Melanosis coli (4130655629).jpg|'''Melanosis coli''', lipofuscin-containing macrophages | ||
+ | File:Histology of subepithelial lymphoid aggregate of the colon.jpg|thumb|'''Subepithelial lymphoid aggregate''', nonspecific, and generally reported as such.<ref group=notes>It is acceptable to not mention a subepithelial lymphoid aggregate at all.</ref> | ||
</gallery> | </gallery> | ||
Line 45: | Line 52: | ||
Example report in an unremarkable biopsy: | Example report in an unremarkable biopsy: | ||
{|class=wikitable | {|class=wikitable | ||
− | | Colonic mucosa | + | | (Colon, biopsy:)<br>Colonic mucosa without significant histopathologic changes. |
|} | |} | ||
+ | In follow-ups of inflammatory bowel disease ('''IBD'''), add "Negative for colitis or dysplasia" if true. | ||
{{Bottom}} | {{Bottom}} |
Revision as of 20:46, 15 July 2021
Author:
Mikael Häggström [note 1]
Mostly: |
This article also includes the rectum.
Contents
Presentations
- Colorectal polyp
- Colon ischemia
- Colon for diverticulitis
- Intestine with tumor
- Colitis
- Hemorrhoids
- Stoma and "donuts"
Gross processing
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.[1] 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.
Microscopic evaluation
Screening
In a general screening, look for:
Hyperplasia and/or atypia (colorectal polyp with tubular adenoma pictured)
- Colitis, such as by neutrophilic infiltration
Common incidental findings
Subepithelial lymphoid aggregate, nonspecific, and generally reported as such.[notes 1]
Microscopy report
Example report in an unremarkable biopsy:
(Colon, biopsy:) Colonic mucosa without significant histopathologic changes. |
In follow-ups of inflammatory bowel disease (IBD), add "Negative for colitis or dysplasia" if true.
Notes
- ↑ It is acceptable to not mention a subepithelial lymphoid aggregate at all.
- ↑ 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
Image sources