Histopathology Report

• Ulcerative colitis:

- Site-related disease activity (healed/quiescent/mild/moderate/severe), rectal sparing, appendiceal and caecal skip lesions, backwash ileiitis, toxic dilatation, superimposed infection (e.g., CMV), DALMs, carcinoma or lymphoma.

- chronic transmural inflammation, granulomas, fissures/fistulae, abscess formation, segmental distribution/appendiceal/ileal disease, malignancy.

- necrosis - mucosal/transmural/gangrenous.

- resection limits - ischaemic/viable.

- mesenteric vessels - thrombosis/embolism/vasculitis.

- miscellaneous - constriction band/volvulus/stricture.

• Pseudo membranous colitis:

- pseudomembranes, ulceration, necrosis, perforation, strictures.

• Obstructive enterocolitis:

- note ulceration/perforation/stricture/distribution and features specific to the aetiolog-ical abnormality.

Neoplastic conditions

• tumour type - adenocarcinoma/malignant lymphoma/other.

• tumour differentiation.

- adenocarcinoma.

- well or moderate/poor.

- malignant lymphoma.

- MALToma/centrocytic/follicle centre cell/Burkitt's/other.

- low-grade/high-grade.

• tumour edge - pushing/infiltrative/lymphoid response.

• extent of local tumour spread (for carcinoma).

- pTis carcinoma in situ: intraepithelial (within basement membrane) or invasion of lamina propria (intramucosal) with no extension through muscularis mucosae into submucosa.

- pT1 tumour invades submucosa.

- pT2 tumour invades muscularis propria.

- pT3 tumour invades through the wall into subserosa or non-peritonealised peri colic/perirectal tissues.

- pT4 tumour invades other organs or structures (e.g., other bowel loops via the serosa)

and/or perforates visceral peritoneum.

• lymphovascular invasion - present/not present.

• regional lymph nodes.

- pericolic, perirectal, those located along the ileocolic, colic, inferior mesenteric, superior rectal and internal iliac arteries.

- pN0 no regional lymph node metastasis.

- pN1 1-3 involved regional lymph node(s).

- pN2 4 or more involved regional lymph nodes.

- A tumour limited to the wall, node negative.

- B tumour beyond the wall, node negative.

- Cj nodes positive, apical node negative.

- C2 apical node positive.

- D distant metastases.

• excision margins.

- proximal and distal longitudinal (cm) and mesocolic/mesorectal circumferential (mm) limits of tumour clearance.

• other pathology.

- adenoma(s), FAPC, ulcerative colitis, Crohn's disease, schistosomiasis.

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