Grossing of colonic lesions

Colon tumor
Other
Grossing of colonic lesions

Author: Charanjeet Singh, M.D. (see Authors page)

Revised: 3 January 2017, last major update May 2012

Copyright: (c) 2003-2017, PathologyOutlines.com, Inc.

PubMed search: histologic sampling colonic lesions

Table of Contents

Diagrams / tables

Cite this page: Grossing of colonic lesions. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/colontumorgrossing.html. Accessed July 14th, 2017.

Diagrams / tables

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Anatomic subsites

Polyps

Fix first for proper sectioning
Take section through surgical margin of stalk (may want to ink first)
Embed entirely to detect high grade dysplasia or invasive carcinoma (Am J Clin Pathol 2001;116:336)

Colectomy - no tumor

Remove mesentery and sample lymph nodes while fresh
Either open bowel and pin overnight to fix, or inject specimen with formalin to fix

Take these sections:

Abnormal areas by taking sections perpendicular to mucosal folds (through bowel wall)
Resection margins
Appendix, terminal ileum, cecum and ileocecal value, if present

Colectomy - tumor

Remove mesentery and dissect lymph nodes while fresh
May use clearing agent to obtain sufficient number of lymph nodes (see staging)
Either open bowel (don't cut through tumor) and pin overnight to fix, or inject specimen with formalin to fix

Take these sections:

Tumor (entire tumor if 5 sections or less or 1 section per cm diameter)
Serosa at point of deepest penetration of tumor (may want to ink serosa first)
Full thickness of bowel wall (may need to split to fit into a cassette)
Resection margins
Appendix, terminal ileum, cecum and ileocecal value, if present
Any abnormalities
Normal appearing bowel