Colon tumor
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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://pathologyoutlines.com/topic/colontumorgrossing.html. Accessed July 27th, 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