Difference between revisions of "Hemorrhoids"
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===Common findings=== | ===Common findings=== | ||
<gallery mode=packed heights=170> | <gallery mode=packed heights=170> | ||
| − | File:Anorectal mucosa with hemorrhoid.jpg| | + | File:Anorectal mucosa with hemorrhoid.jpg|'''Hyperplasia''' (anorectal mucosa shown) |
File:Histopathology of pagetoid dyskeratosis in epidermis of hemorrhoid.jpg|'''Pagetoid dyskeratosis''', with pale cells, occurs in most hemorrhoids. Look mainly for nuclear enlargement, which may indicate [[koilocyte]]s (having raisin-like dark nuclei), extramammary Paget's disease (having prominent nucleoli)<ref>{{cite web|url=https://plasticsurgerykey.com/mammary-and-extramammary-pagets-disease/#56061750|title=Mammary and Extramammary Paget’s Disease|website=Palstic Surgery Key|date=2016-06-11}}</ref> or superficial spread of carcinoma or [[melanoma]] (look at basal layer and surrounding epidermis.<ref name="pmid11473458">{{cite journal| author=Val-Bernal JF, Pinto J| title=Pagetoid dyskeratosis is a frequent incidental finding in hemorrhoidal disease. | journal=Arch Pathol Lab Med | year= 2001 | volume= 125 | issue= 8 | pages= 1058-62 | pmid=11473458 | doi=10.5858/2001-125-1058-PDIAFI | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11473458 }} </ref> | File:Histopathology of pagetoid dyskeratosis in epidermis of hemorrhoid.jpg|'''Pagetoid dyskeratosis''', with pale cells, occurs in most hemorrhoids. Look mainly for nuclear enlargement, which may indicate [[koilocyte]]s (having raisin-like dark nuclei), extramammary Paget's disease (having prominent nucleoli)<ref>{{cite web|url=https://plasticsurgerykey.com/mammary-and-extramammary-pagets-disease/#56061750|title=Mammary and Extramammary Paget’s Disease|website=Palstic Surgery Key|date=2016-06-11}}</ref> or superficial spread of carcinoma or [[melanoma]] (look at basal layer and surrounding epidermis.<ref name="pmid11473458">{{cite journal| author=Val-Bernal JF, Pinto J| title=Pagetoid dyskeratosis is a frequent incidental finding in hemorrhoidal disease. | journal=Arch Pathol Lab Med | year= 2001 | volume= 125 | issue= 8 | pages= 1058-62 | pmid=11473458 | doi=10.5858/2001-125-1058-PDIAFI | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11473458 }} </ref> | ||
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*Diagnosis of '''hemorrhoids''' | *Diagnosis of '''hemorrhoids''' | ||
*{{Moderate-begin}}Even benign epithelium, with specification of types seen, that is, anoderm, rectal, or anorectal if both are seen.{{Moderate-end}} | *{{Moderate-begin}}Even benign epithelium, with specification of types seen, that is, anoderm, rectal, or anorectal if both are seen.{{Moderate-end}} | ||
| + | *{{Moderate-begin}}Description of thrombi.{{Moderate-end}} | ||
*{{Comprehensive-begin}}Any epidermal hyperplasia and/or Pagetoid dyskeratosis.{{Comprehensive-end}} | *{{Comprehensive-begin}}Any epidermal hyperplasia and/or Pagetoid dyskeratosis.{{Comprehensive-end}} | ||
:'''Example''': | :'''Example''': | ||
{|class=wikitable | {|class=wikitable | ||
| − | | {{Moderate-begin}}Anal tissue, excision:<br>{{Moderate-end}} | + | | {{Moderate-begin}}Anal tissue, excision:<br>{{Moderate-end}}Hemorrhoids {{Moderate-begin}}with organizing thrombi, and benign anorectal mucosa.{{Moderate-end}} |
|} | |} | ||
{{Bottom}} | {{Bottom}} | ||
Revision as of 08:17, 27 September 2021
Author:
Mikael Häggström [note 1]
Contents
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
- 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
Hyperplasia (anorectal mucosa shown)
Pagetoid dyskeratosis, with pale cells, occurs in most hemorrhoids. Look mainly for nuclear enlargement, which may indicate koilocytes (having raisin-like dark nuclei), extramammary Paget's disease (having prominent nucleoli)[2] or superficial spread of carcinoma or melanoma (look at basal layer and surrounding epidermis.[3]
Microscopic report
- Diagnosis of hemorrhoids
- (Even benign epithelium, with specification of types seen, that is, anoderm, rectal, or anorectal if both are seen.)
- (Description of thrombi.)
- ((Any epidermal hyperplasia and/or Pagetoid dyskeratosis.))
- Example:
| (Anal tissue, excision: )Hemorrhoids (with organizing thrombi, and benign anorectal mucosa.) |
Notes
- ↑ 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
- ↑ Elliot Weisenberg, M.D.. Anus & perianal area - Other nonneoplastic - Hemorrhoids. Pathology Outlines. Topic Completed: 1 May 2014. Minor changes: 7 June 2021
- ↑ . Mammary and Extramammary Paget’s Disease. Palstic Surgery Key (2016-06-11).
- ↑ 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:. PMID 11473458. Archived from the original. .
Image sources
