Difference between revisions of "Anus"
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*Itching. | *Itching. | ||
*Prolapse. | *Prolapse. | ||
===Gross=== | |||
Features:<ref name=Ref_GLP401>{{Ref GLP|401}}</ref> | |||
*Grey mucosa. | |||
*Pale or purple stroma. | |||
===Microscopic=== | ===Microscopic=== | ||
Features:<ref name=Ref_GLP401>{{Ref GLP|401}}</ref> | Features:<ref name=Ref_GLP401>{{Ref GLP|401}}</ref> | ||
*Polypoid lesion - epithelium on three sides: | *Polypoid lesion - epithelium on three sides: | ||
**Large dilated veins +/- fibrin thrombi. | **Large dilated veins and thick-walled vessels +/- fibrin thrombi - '''key feature'''. | ||
**Edema. | **Edema. | ||
**Squamous epithelium +/- keratinization ''or'' columnar epithelium. | **Squamous epithelium +/- keratinization ''or'' columnar epithelium. | ||
DDx: | |||
*[[Fibroepithelial polyp]]. | |||
*Vascular lesions. | |||
**[[Kaposi sarcoma]]. | |||
**[[Angiosarcoma]]. | |||
==See also== | ==See also== | ||
Revision as of 23:55, 15 August 2012
The anus occasionally shows-up on the pathologists desk. It sometimes comes with the rectum and colon, as an abdominoperoneal resection (APR).
Anal neoplasia
Immunosuppressed individuals and homosexuals have a higher risk of anal intraepithelial neoplasia (AIN) and anal cancer.[1][2]
Anal intraepithelial neoplasia
- Abbreviated AIN.
General
- Precursor lesion of anal cancer.
- Usually HPV associated.
Grading
AIN is graded much like cervical intraepithelial neoplasia:
- High-grade anal intraepithelial neoplasia (HGAIN).
- Low-grade anal intraepithelial neoplasia (LGAIN).
Anal cancer
- Squamous cell carcinoma - most common.
- Malignant melanoma.
- Adenocarcinoma from the rectum.
Hidradenoma papilliferum
Hemorrhoids
General
- Benign.
Clinical features:[3]
- Bright red blood per rectum (BRBPR).
- Pain.
- Itching.
- Prolapse.
Gross
Features:[4]
- Grey mucosa.
- Pale or purple stroma.
Microscopic
Features:[4]
- Polypoid lesion - epithelium on three sides:
- Large dilated veins and thick-walled vessels +/- fibrin thrombi - key feature.
- Edema.
- Squamous epithelium +/- keratinization or columnar epithelium.
DDx:
- Fibroepithelial polyp.
- Vascular lesions.
See also
References
- ↑ Park IU, Palefsky JM (March 2010). "Evaluation and Management of Anal Intraepithelial Neoplasia in HIV-Negative and HIV-Positive Men Who Have Sex with Men". Curr Infect Dis Rep 12 (2): 126–133. doi:10.1007/s11908-010-0090-7. PMC 2860554. PMID 20461117. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2860554/.
- ↑ Czoski-Murray C, Karnon J, Jones R, Smith K, Kinghorn G (November 2010). "Cost-effectiveness of screening high-risk HIV-positive men who have sex with men (MSM) and HIV-positive women for anal cancer". Health Technol Assess 14 (53): 1–131. doi:10.3310/hta14530. PMID 21083999.
- ↑ Cazemier, M.; Felt-Bersma, RJ.; Cuesta, MA.; Mulder, CJ. (Jan 2007). "Elastic band ligation of hemorrhoids: flexible gastroscope or rigid proctoscope?". World J Gastroenterol 13 (4): 585-7. PMID 17278225.
- ↑ 4.0 4.1 Iacobuzio-Donahue, Christine A.; Montgomery, Elizabeth A. (2005). Gastrointestinal and Liver Pathology: A Volume in the Foundations in Diagnostic Pathology Series (1st ed.). Churchill Livingstone. pp. 401. ISBN 978-0443066573.