Histopathology Report

Ischaemia

• necrosis - mucosal/transmural/gangrenous.

• resection limits - ischaemic/viable.

• mesenteric vessels - thrombosis/embolism/vasculitis.

• miscellaneous - constriction band/volvulus/intussusception/stricture.

Crohn's Disease

• chronic transmural inflammation/granulomas/fissures/fistulae/abscess formation/ileal con-fined/ileo-caecal/appendiceal or resection limit disease/malignancy.

1. Transverse section the surgical limits

2. Process the appendix as usual

3. Sample normal ileum and colon

4. Sample representative blocks of the hose pipe segment, any ulceration and adjacent mucosa.

5. Sample mesenteric lymph nodes

Figure 4.6. Right hemicolectomy for Crohn's disease.

Intussusception

• apex/secondary ulceration, stricture, ischaemia or perforation/site (ileo-ileal/ileo-caecal).

Neoplastic Conditions

- adenocarcinoma/malignant lymphoma/GIST.

• tumour differentiation

- adenocarcinoma well/moderate/poor.

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

low-grade/high-grade.

- GIST spindle cell/epithelioid.

cellularity/atypia/necrosis/mitoses/margins/size. leiomyomatous/neural/stromal (CD34, CD117).

- pushing/infiltrative/lymphoid response.

• extent of local tumour spread (for carcinoma).

- pTis carcinoma in situ

- pT1 tumour invades lamina propria or submucosa

- pT2 tumour invades muscularis propria

- pT3 tumour invades through the wall into subserosa or perimuscular connective tissues (mesentery or retroperitoneum) with extension < 2 cm.

- pT4 tumour perforates the serosa or invades other organs/structures, e.g., mesen tery > 2 cm, small bowel loops, abdominal wall.

• lymphovascular invasion - present/not present

• regional lymph nodes

- duodenum: pancreatioduodenal, pyloric, hepatic, superior mesenteric nodes.

- ileum/jejunum: mesenteric.

- terminal ileum: ileocolic, posterior caecal.

- pN0 no regional lymph node metastasis.

- pN1 metastasis in regional lymph node(s).

• excision margins

- proximal, distal and mesenteric limits of tumour clearance (cm).

• other pathology

- FAPC, Peutz-Jegher's syndrome, Crohn's disease, coeliac disease, EATCL.

0 0

Post a comment