Gross pathology

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.

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.
• Arrhythmogenic 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 pathology

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

Uterine cervix:

• Cervical carcinoma.

Dermatopathology

Tumour:

• Basal cell carcinoma.
• Squamous cell carcinoma.
• Malignant melanoma.

Possible syndromic:

• Seborrheic keratosis - Leser–Trélat sign
• Neurofibroma - neurofibromatosis.
• Angiofibroma - Fabry disease.

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.
• Cerebral contusion.
  • Plaque jaune.

Genitourinary pathology

Kidney:

• Clear cell renal cell carcinoma - yellow.
• Papillary renal cell carcinoma - friable.
• Chromophobe renal cell carcinoma - brown +/-hemorrhage, no central scar.
• Renal oncocytoma - brown, central scar.
• Autosomal dominant polycystic kidney disease.
• Angiomyolipoma - fat.

Testis:

• Seminoma.
• Mixed germ cell tumour.
• Leydig cell tumour - brown.
• Testicular torsion.

Paratesticular:

• Liposarcoma.

Placenta

Membranes:

• Marginal inserion - normal.
• Circumvallate insertion.
• Circummarginate insertion.

Disc:

• Retroplacental blood clot - suggestive of placental abruption.
• Chorangioma - big red intraparenchymal.
• Placental infarct - white = old, red = recent.
• Twin-to-twin transfusion syndrome - one side beefy red the other pale.
• Meconium staining/chorioamnionitis.

Cord:

• Two vessel umbilical cord.
• False knot.
• True knot.

See also

• Basics.

External links

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