Gross pathology
Gross pathology, also simply gross, refers to the macroscopic pathology, and the macroscopic assessment of pathology specimens. It may include preparation of tissue for a microscopic examination. 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
- 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 - mid esophagus classically.
- Adenocarcinoma - distal esophagus.
- Barrett's esophagus.
- Esophageal varices.
- Esophageal perforation.
Stomach:
- Malignant gastric ulcer.
- Peptic ulcer.
- Gastric antral vascular ectasia.
- Leopard spots - seen in hypothermia.
- 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) - seen in congestive heart failure.
- Hepatic infarct - classically at the periphery, red and wedge-shaped.
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.
- Fibroma.
- Brenner tumour - may be yellow, typically solid.
- Endometrioma.
Uterine tube:
- Ectopic pregnancy.
- Tubal abscess.
- Adenomatoid tumour.
Uterus:
- Adenomyosis.
- Leiomyoma - multiple.
- Endometrial carcinoma.
- Leiomyosarcoma - friable, solitary, fish flesh.
- Bicornuate uterus.
- Uterus didelphys.
Uterine cervix:
- Nabothian cyst.
- Cervical polyp.
- Cervical carcinoma.
Dermatopathology
Tumour:
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.
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:
Placenta
Membranes:
- Marginal inserion - normal.
- Circumvallate placenta.
- Circummarginate placenta.
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.
- Amnion nodosum.
- Squamous metaplasia of the amnion.
Cord:
- Two vessel umbilical cord.
- False knot.
- True knot.
- Membranous insertion (AKA velamentous insertion).
- Furcate insertion - vessels separate before inserting.
Fetal
Genetic:
See also
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.