Difference between revisions of "Gross pathology"

Revision as of 15:33, 16 April 2012

Gross pathology is the macroscopic assessment of pathology specimens. It is an essential part of pathologic assessments.

Gross only

Which specimens are "gross only" typically depends on institutional policy.^[1]

Gross spot diagnosis

Heart

Heart valve:

Infective endocarditis.
Bicuspid aortic valve.
Nonbacterial thrombotic endocarditis - non-distructive.
Rheumatic heart disease - fish mouth valve, thick cordae tendinae.
Calcific aortic stenosis.

Heart - other:

Fibrinous pericarditis.
Hypertrophic cardiomyopathy - septal thickness > free wall thickness.
Cardiac hypertrophy.
Dilated cardiomyopathy.
Right ventricular cardiomyopathy.

Cardiovascular

Aortic dissection.
Aortic rupture.
Cerebral aneurysm.

Lungs

Pulmonary thromboembolism.
Lung abscess.
Lung tumour (primary).
Metatstatic tumour lung - usu. multiple and peripheral.
Malignant mesothelioma.
Pleural plaques.
Emphysema.
Pneumothorax.
Hemothorax.
Hypoplasia secondary to diaphragmatic hernia.

Gastrointestinal

Esophagus:

Squamous cell carcinoma.
Adenocarcinoma.
Barrett's esophagus.
Esophageal varices.
Esophageal perforation.

Stomach:

Malignant gastric ulcer.
Peptic ulcer.
Gastric antral vascular ectasia.
Leopard spots.
GIST.

Duodenum:

Peptic ulcer.
Duodenal adenocarcinoma - classically assoc. with FAP.

Liver:

Cirrhosis.
Hydatid cyst.
Hepatocellular carcinoma - in the context of cirrhosis.
Metastases.
Hemangioma.
Focal nodular hyperplasia.
Hepatic adenoma.
Cholangiocarcinoma.
Congestive hepatopathy (nutmeg liver).

Gallbladder:

Pancreas:

Solid pseudopapillary neoplasm - with age & sex provided.
Pancreatic adenocarcinoma.
Neuroendocrine tumour.
Chronic pancreatitis.

Small bowel:

Ischemic small bowel.
Meckel's diverticulum.
Intussusception.
Neuroendocrine tumour - if on section.
GIST.
Incarcerated hernia.

Appendix:

Acute appendicitis.
Neuroendocrine tumour.
Mucinous tumour.

Large bowel:

Colorectal adenocarcinoma.
Bowel infarction.
Ulcerative colitis - no skip lesions, no wall thickening.
Crohn's disease - creeping fat, cobble stone pattern, skip lesions, fistulas.
Pseudomembranous colitis.

Gynecologic pathology

Ovary:

Mucinous tumour.
Mature teratoma.
Serous cystadenoma.

Tube:

Ectopic pregnancy.
Tubal abscess.

Uterus:

Adenomyosis.
Leiomyoma - multiple.
Endometrial carcinoma.
Leiomyosarcoma - friable, solitary, fish flesh.

Neuropathology

Bleeds:

Tumours:

Meningioma - intradural, extramedullary.
Glioma.
Schwannoma - cerebellopontine angle.
Myxopapillary ependymoma - filum terminale.

Non-tumour:

Diffuse axonal injury - classically corpus callosum.
Fat embolism.

References

↑ Zarbo, RJ.; Nakhleh, RE. (Feb 1999). "Surgical pathology specimens for gross examination only and exempt from submission: a College of American Pathologists Q-Probes study of current policies in 413 institutions.". Arch Pathol Lab Med 123 (2): 133-9. doi:10.1043/0003-9985(1999)1230133:SPSFGE2.0.CO;2. PMID 10050786.

External links

Old (black & white) gross pathology (artandmedicine.com).

[pmid10050786-1] Zarbo, RJ.; Nakhleh, RE. (Feb 1999). "Surgical pathology specimens for gross examination only and exempt from submission: a College of American Pathologists Q-Probes study of current policies in 413 institutions.". Arch Pathol Lab Med 123 (2): 133-9. doi:10.1043/0003-9985(1999)1230133:SPSFGE2.0.CO;2. PMID 10050786.

[1]

@@ Line 9: / Line 9: @@
 *[[Infective endocarditis]].
 *[[Bicuspid aortic valve]].
-*[[Nonbacterial thrombotic endocarditis]].
+*[[Nonbacterial thrombotic endocarditis]] - non-distructive.
-*[[Rheumatic heart disease]].
+*[[Rheumatic heart disease]] - fish mouth valve, thick cordae tendinae.
 *[[Calcific aortic stenosis]].
 Heart - other:
@@ Line 18: / Line 18: @@
 *[[Dilated cardiomyopathy]].
 *[[Right ventricular cardiomyopathy]].
+===Cardiovascular===
+*[[Aortic dissection]].
+*Aortic rupture.
+*Cerebral aneurysm.
 ===Lungs===
@@ Line 32: / Line 37: @@
 ===Gastrointestinal===
+Esophagus:
+*Squamous cell carcinoma.
+*Adenocarcinoma.
+*[[Barrett's esophagus]].
+*Esophageal varices.
+*Esophageal perforation.
+Stomach:
 *Malignant gastric ulcer.
 *Peptic ulcer.
 *[[Gastric antral vascular ectasia]].
 *[[Leopard spots]].
+*[[GIST]].
+Duodenum:
+*Peptic ulcer.
+*Duodenal adenocarcinoma - classically assoc. with [[FAP]].
+Liver:
+*[[Cirrhosis]].
+*[[Hydatid cyst]].
+*[[Hepatocellular carcinoma]] - in the context of cirrhosis.
+*[[Metastases]].
+*[[Hemangioma]].
+*[[Focal nodular hyperplasia]].
+*[[Hepatic adenoma]].
+*[[Cholangiocarcinoma]].
+*Congestive hepatopathy (nutmeg liver).
+Gallbladder:
+*[[Cholelithiasis]].
+*[[Cholesterolosis of the gallbladder]].
+*Gallbladder polyp.
+Pancreas:
+*[[Solid pseudopapillary neoplasm]] - with age & sex provided.
+*[[Pancreatic adenocarcinoma]].
+*[[Neuroendocrine tumour]].
+*[[Chronic pancreatitis]].
+Small bowel:
+*Ischemic small bowel.
+*[[Meckel's diverticulum]].
+*[[Intussusception]].
+*Neuroendocrine tumour - if on section.
+*[[GIST]].
+*Incarcerated hernia.
+Appendix:
+*[[Acute appendicitis]].
+*Neuroendocrine tumour.
+*Mucinous tumour.
+Large bowel:
+*[[Colorectal adenocarcinoma]].
+*Bowel infarction.
+*[[Ulcerative colitis]] - no skip lesions, no wall thickening.
+*[[Crohn's disease]] - creeping fat, cobble stone pattern, skip lesions, fistulas.
+*[[Pseudomembranous colitis]].
+===Gynecologic pathology===
+Ovary:
+*Mucinous tumour.
+*Mature teratoma.
+*Serous cystadenoma.
+Tube:
+*Ectopic pregnancy.
+*Tubal abscess.
+Uterus:
+*[[Adenomyosis of the uterus|Adenomyosis]].
+*[[Uterine leiomyoma|Leiomyoma]] - multiple.
+*Endometrial carcinoma.
+*[[Uterine leiomyosarcoma|Leiomyosarcoma]] - friable, solitary, fish flesh.
+===Neuropathology===
+Bleeds:
+*[[Epidural hematoma]]
+*[[Subdural hematoma]].
+*[[Subarachnoid hematoma]] - [[berry aneurysm]].
+*[[Intracerebral hematoma]].
+Tumours:
+*Meningioma - intradural, extramedullary.
+*Glioma.
+*[[Schwannoma]] - cerebellopontine angle.
+*Myxopapillary ependymoma - filum terminale.
+Non-tumour:
+*[[Diffuse axonal injury]] - classically corpus callosum.
+*[[Fat embolism]].
 ==See also==