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The '''colon''' smells like [[poo]]... 'cause that's where poo comes from.  This article also covers the '''rectum''' and '''cecum''' as both have a similar mucosa.   
[[Image:Blausen_0603_LargeIntestine_Anatomy.png|thumb|right|Anatomy of the colon and rectum. (WC)]]
The '''colon''' is section of the large bowel.  This article also covers the '''rectum''' and '''cecum''' as both have a similar mucosa.   


It commonly comes to pathologists because there is a suspicion of [[colorectal cancer]] or a known history of [[inflammatory bowel disease]] (IBD).  
It commonly comes to pathologists because there is a suspicion of [[colorectal cancer]] or a known history of [[inflammatory bowel disease]] (IBD).


An introduction to gastrointestinal pathology is found in the ''[[gastrointestinal pathology]]'' article.  The ''[[anus]]'' and ''[[ileocecal valve]]'' are dealt with in separate articles.
An introduction to gastrointestinal pathology is found in the ''[[gastrointestinal pathology]]'' article.  The ''[[anus]]'' and ''[[ileocecal valve]]'' are dealt with in separate articles.


Technically, the rectum and cecum are ''not'' part of the colon.  Thus, inflammation of the rectum should be ''proctitis'' and inflammation of the cecum should be ''cecitis''.
Technically, the rectum and cecum are ''not'' part of the colon.  Thus, inflammation of the rectum should be ''proctitis'' and inflammation of the cecum should be ''cecitis''.
=Anatomy=
*The [[rectum]] has several definition. These are discussed in the ''[[rectum]]'' article.
*The large bowel may be submitted with segment names or with the distance to the anal verge.
A conversion between named segments and distance - as per NCI of the United States:<ref>URL: [https://training.seer.cancer.gov/colorectal/anatomy/figure/figure1.html]https://training.seer.cancer.gov/colorectal/anatomy/figure/figure1.html]. Accessed on: 8 February 2018.</ref>
{| class="wikitable sortable"
!Named segment
!Distance to anal verge (cm)
|-
|Anus
|0-4
|-
|[[Rectum]]
|4-16
|-
|Rectosigmoid
|15-17
|-
|Sigmoid
|17-57
|-
|Descending
|57-82
|-
|Transverse
|82-132
|-
|Ascending
|132-147
|-
|Cecum
|150
|}


=Common clinical problems=
=Common clinical problems=
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# Subtotal colectomy - part of colon removed --or-- some of the rectum remains.
# Subtotal colectomy - part of colon removed --or-- some of the rectum remains.
# Right hemicolectomy - right colon + distal ileum.
# Right hemicolectomy - right colon + distal ileum.
# Lower anterior resection (LAR) - proximal rectum +/- sigmoid (for proximal rectal malignancies).
# [[Lower anterior resection]] (LAR) - proximal rectum +/- sigmoid (for proximal rectal malignancies).
#* Specimens have should have intact mesorectum - ''total mesorectal excision'' (TME) - reduces local recurrence.<ref name=pmid8665198>{{Cite journal  | last1 = Arbman | first1 = G. | last2 = Nilsson | first2 = E. | last3 = Hallböök | first3 = O. | last4 = Sjödahl | first4 = R. | title = Local recurrence following total mesorectal excision for rectal cancer. | journal = Br J Surg | volume = 83 | issue = 3 | pages = 375-9 | month = Mar | year = 1996 | doi =  | PMID = 8665198 }}</ref>  
#* Specimens have should have intact mesorectum - ''[[total mesorectal excision]]'' (TME) - reduces local recurrence.<ref name=pmid8665198>{{Cite journal  | last1 = Arbman | first1 = G. | last2 = Nilsson | first2 = E. | last3 = Hallböök | first3 = O. | last4 = Sjödahl | first4 = R. | title = Local recurrence following total mesorectal excision for rectal cancer. | journal = Br J Surg | volume = 83 | issue = 3 | pages = 375-9 | month = Mar | year = 1996 | doi =  | PMID = 8665198 }}</ref>  
# Abdominoperineal resection (APR) - anus + rectum - results in a permanent [[stoma]] (for distal rectal malignancies).
# [[Abdominoperineal resection]] (APR) - anus + rectum - results in a permanent [[stoma]] (for distal rectal malignancies).
# [[Stoma]] - these are often done emergently and then get cut-out after the patient's condition has settled.
# [[Stoma]] - these are often done emergently and then get cut-out after the patient's condition has settled.
#[[Doughnuts]] (also ''donuts'') from an end-to-end anastomosis stapler.
#*Often accompany lower anterior resections.


===Images===
===Images===
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**Rectum starts/sigmoid ends @ place where serosa ends on the posterior aspect of the bowel.
**Rectum starts/sigmoid ends @ place where serosa ends on the posterior aspect of the bowel.
***The proximal, anterior aspect of the rectum has serosa, i.e. it is not painted.
***The proximal, anterior aspect of the rectum has serosa, i.e. it is not painted.
Note:
*There are several definitions for the rectum.<ref name=pmid24130630>{{Cite journal  | last1 = Kenig | first1 = J. | last2 = Richter | first2 = P. | title = Definition of the rectum and level of the peritoneal reflection - still a matter of debate? | journal = Wideochir Inne Tech Maloinwazyjne | volume = 8 | issue = 3 | pages = 183-6 | month = Sep | year = 2013 | doi = 10.5114/wiitm.2011.34205 | PMID = 24130630 }}</ref>
**In a survey of surgeons:
**67% defined it by an anatomical landmark
***35% of all respondants considered the peritoneal reflection the proximal boundary of the rectum.
**30% defined the proximal boundary as a distance from the anal verge.


=Common non-neoplastic disease=
=Common non-neoplastic disease=
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==Volvulus==
==Volvulus==
===General===
{{Main|Volvulus}}
*Uncommonly comes to pathology.
*It is essentially a radiologic diagnosis.
*In the context of [[autopsy]], it is a gross diagnosis.
 
===Gross===
*Intestine folded over itself - typically leads to ischemia.
 
Images:
*[http://library.med.utah.edu/WebPath/GIHTML/GI032.html Cecal volvulus (utah.edu)].
*[http://pathsrvr.rockford.uic.edu/inet/GI/Photo%202%20-%20Volvulus%20of%20small%20intestine_%20gross.gif Volvulus (uic.edu)].<ref>URL: [http://pathsrvr.rockford.uic.edu/inet/GI/GI%20Station%201.htm http://pathsrvr.rockford.uic.edu/inet/GI/GI%20Station%201.htm]. Accessed on: 9 April 2012.</ref>
 
===Microscopic===
Features:
*+/-Ischemic changes and/or [[necrosis]].
 
DDx - essentially anything that causes ischemia:
*Embolus.
*Thrombosis.
*[[Vasculitis]].
 
===Sign out===
<pre>
RECTOSIGMOID, RESECTION:
- MURAL ISCHEMIA WITH PERFORATION, SEROSITIS, MICROABSCESS FORMATION AND POORLY FORMED PSEUDOMEMBRANES.
- SUBMUCOSAL FIBROSIS.
- NEGATIVE FOR MALIGNANCY.
 
COMMENT:
The findings are consistent with volvulus and the submucosal fibrosis suggests this may have been recurrent.
</pre>


=Inflammatory diseases=
=Inflammatory diseases=
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*Basal, i.e. crypt base, plasmacytosis with severe chronic inflammation,
*Basal, i.e. crypt base, plasmacytosis with severe chronic inflammation,
*Crypt architectural abnormalities, and
*Crypt architectural abnormalities, and
*Distal Paneth cell metaplasia.
*Distal [[Paneth cell]] metaplasia.
**Paneth cells should ''not'' be in the left colon<ref name=pmid11851832>{{cite journal |author=Tanaka M, Saito H, Kusumi T, ''et al'' |title=Spatial distribution and histogenesis of colorectal Paneth cell metaplasia in idiopathic inflammatory bowel disease |journal=J. Gastroenterol. Hepatol. |volume=16 |issue=12 |pages=1353–9 |year=2001 |month=December |pmid=11851832 |doi= |url=http://www3.interscience.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0815-9319&date=2001&volume=16&issue=12&spage=1353}}</ref> - if you see 'em think of IBD and other long-standing injurious processes.
**Paneth cells should ''not'' be in the left colon<ref name=pmid11851832>{{cite journal |author=Tanaka M, Saito H, Kusumi T, ''et al'' |title=Spatial distribution and histogenesis of colorectal Paneth cell metaplasia in idiopathic inflammatory bowel disease |journal=J. Gastroenterol. Hepatol. |volume=16 |issue=12 |pages=1353–9 |year=2001 |month=December |pmid=11851832 |doi= |url=http://www3.interscience.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0815-9319&date=2001&volume=16&issue=12&spage=1353}}</ref> - if you see 'em think of IBD and other long-standing injurious processes.
**Some claim that (friendly right colonic) paneth cells and paneth cell metaplasia look quite different and can be distinguished.<ref name=pmid12655793>{{cite journal |author=Rubio CA, Nesi G |title=A simple method to demonstrate normal and metaplastic Paneth cells in tissue sections |journal=In Vivo |volume=17 |issue=1 |pages=67–71 |year=2003 |pmid=12655793 |doi= |url=}}</ref>
**Some claim that (friendly right colonic) paneth cells and paneth cell metaplasia look quite different and can be distinguished.<ref name=pmid12655793>{{cite journal |author=Rubio CA, Nesi G |title=A simple method to demonstrate normal and metaplastic Paneth cells in tissue sections |journal=In Vivo |volume=17 |issue=1 |pages=67–71 |year=2003 |pmid=12655793 |doi= |url=}}</ref>
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==Eosinophilic colitis==
==Eosinophilic colitis==
===General===
*Abbreviated ''EC''.
*Rare.
{{Main|Eosinophilic colitis}}
*May be a component of ''[[eosinophilic gastroenteritis]]''.<ref name=pmid22012125/>
 
Clinical features:<ref name=pmid22012125/>
*Abdominal pain
*Diarrhea +/-blood.
*+/-Weight loss.
 
===Gross===
Features - endoscopic:<ref name=pmid22012125>{{Cite journal  | last1 = Alfadda | first1 = AA. | last2 = Storr | first2 = MA. | last3 = Shaffer | first3 = EA. | title = Eosinophilic colitis: an update on pathophysiology and treatment. | journal = Br Med Bull | volume = 100 | issue =  | pages = 59-72 | month =  | year = 2011 | doi = 10.1093/bmb/ldr045 | PMID = 22012125 | PMC = 3165205 }}</ref>
*Edema.
*Granular appearance.
 
===Microscopic===
Features:<ref name=pmid22012125/>
*Abundant eosinophils - no agreed upon number.
**"Most use 20/[[HPF]]" <ref name=pmid19554649>{{Cite journal  | last1 = Okpara | first1 = N. | last2 = Aswad | first2 = B. | last3 = Baffy | first3 = G. | title = Eosinophilic colitis. | journal = World J Gastroenterol | volume = 15 | issue = 24 | pages = 2975-9 |  month = Jun | year = 2009 | doi =  | PMID = 19554649 | PMC = 2702104 }}</ref> - a definition that suffers from [[HPFitis]].
***There is variation along the large bowel - normal in rectum <10/HPF, normal in cecum <30/HPF (???).<ref name=pmid19554649/>
 
DDx:<ref name=pmid22012125/>
*[[Inflammatory bowel disease]]:
**[[Crohn's disease]].
**[[Ulcerative colitis]].
*Infection:
**[[Pinworm]].
**[[Strongyloidiasis]].
*Autoimmune disease:
**[[Scleroderma]].
**[[Churg-Strauss syndrome]].
**[[Celiac disease]].
*[[Drug reaction]]s.
 
Image:
*[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2702104/figure/F1/ EC (nih.gov)].<ref name=pmid19554649>{{Cite journal  | last1 = Okpara | first1 = N. | last2 = Aswad | first2 = B. | last3 = Baffy | first3 = G. | title = Eosinophilic colitis. | journal = World J Gastroenterol | volume = 15 | issue = 24 | pages = 2975-9 | month = Jun | year = 2009 | doi =  | PMID = 19554649 | PMC = 2702104 }}</ref>
 
===Sign out===
<pre>
DESCENDING COLON, BIOPSY:
- COLONIC MUCOSA WITH MILD EOSINOPHILIA, SEE COMMENT.
- NEGATIVE FOR DYSPLASIA.
 
COMMENT:
Focally, there are up to 40 eosinophils / 0.2376 mm*mm (approx. field area at 400X). This
is a non-specific finding. No eosinophilic crypt abscesses are seen. No (neutrophilic)
cryptitis is present. Clinical correlation is suggested.
</pre>
 
<pre>
DESCENDING COLON, BIOPSY:
- COLONIC MUCOSA WITH MILD EOSINOPHILIA, SEE COMMENT.
- NEGATIVE FOR ACTIVE COLITIS.
- NEGATIVE FOR DYSPLASIA.
 
COMMENT:
There are up to 40 eosinophils / 0.2376 mm*mm (field area at 400X). This is a
non-specific finding.  The differential diagnosis includes inflammatory bowel
disease, infection (especially helminths), a drug reaction, and autoimmune
disorders (e.g. Churg-Strauss syndrome, celiac disease, scleroderma). Clinical
correlation is required.
</pre>


=Infectious=
=Infectious=
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{{Main|CMV}}
{{Main|CMV}}
*Abbreviated ''CMV colitis''.
*Abbreviated ''CMV colitis''.
===General===
{{Main|Cytomegalovirus colitis}}
*Uncommon.
*Immunosuppressed population at risk, e.g. transplant recipients, individuals with [[HIV]].
 
===Microscopic===
Features:
*Enlarged nucleus - classically in endothelial cells.
 
DDx:
*[[Infectious colitis]] without a distinctive morphology.
*CMV colitis superimposed on [[inflammatory bowel disease]].
 
====Images====
<gallery>
Image:CMV_colitis_-_intermed_mag.jpg | CMV colitis - intermed. mag. (WC/Nephron)
Image:CMV_colitis_-_high_mag_-_cropped.jpg | CMV colitis - high mag. (WC/Nephron)
</gallery>
www:
*[http://www.flickr.com/photos/lunarcaustic/4615988256/ CMV colitis (flickr.com/lunar caustic)].
*[http://www.flickr.com/photos/lunarcaustic/4615988164/ CMV colitis (flickr.com/lunar caustic)]
===IHC===
*CMV +ve.
 
Others:
*HSV-1.
*HSV-2.
*VZV.
*[[EBV]].


==Intestinal spirochetosis==
==Intestinal spirochetosis==
*[[AKA]] ''intestinal spirochetes''; more specifically ''colonic spirochetes'', ''colonic spirochetosis''.
*[[AKA]] ''intestinal spirochetes''; more specifically ''colonic spirochetes'', ''colonic spirochetosis''.
 
{{Main|Intestinal spirochetosis}}
===General===
*Caused by spirochetes<ref name=pmid14718105>{{cite journal |author=Amat Villegas I, Borobio Aguilar E, Beloqui Perez R, de Llano Varela P, Oquiñena Legaz S, Martínez-Peñuela Virseda JM |title=[Colonic spirochetes: an infrequent cause of adult diarrhea] |language=Spanish; Castilian |journal=Gastroenterol Hepatol |volume=27 |issue=1 |pages=21–3 |year=2004 |month=January |pmid=14718105 |doi= |url=}}</ref><ref name=jhasim>URL: [http://www.jhasim.com/files/articlefiles/pdf/XASIM_Master_6_5_May_Vignette.pdf http://www.jhasim.com/files/articlefiles/pdf/XASIM_Master_6_5_May_Vignette.pdf]. Accessed on: 25 April 2011.</ref> - specifically ''Brachyspira piloicoli''<ref name=pmid19141744>{{Cite journal  | last1 = Margawani | first1 = KR. | last2 = Robertson | first2 = ID. | last3 = Hampson | first3 = DJ. | title = Isolation of the anaerobic intestinal spirochaete Brachyspira pilosicoli from long-term residents and Indonesian visitors to Perth, Western Australia. | journal = J Med Microbiol | volume = 58 | issue = Pt 2 | pages = 248-52 | month = Feb | year = 2009 | doi = 10.1099/jmm.0.004770-0 | PMID = 19141744 | url = http://ukpmc.ac.uk/abstract/MED/19141744/abstract/MED/19141744?ukpmc_extredirect=http://dx.doi.org/10.1099/jmm.0.004770-0 }}</ref> (previously ''Serpulina pilosicoli''<ref>URL: [http://www.cdc.gov/ncidod/eid/vol12no05/05-1180.htm http://www.cdc.gov/ncidod/eid/vol12no05/05-1180.htm]. Accessed on: 28 June 2011.</ref>) and ''Brachyspira aalborgi''.
*Very rare cause of diarrhea, associated with male homosexual behaviour.
 
Symptoms:<ref name=jhasim>URL: [http://www.jhasim.com/files/articlefiles/pdf/XASIM_Master_6_5_May_Vignette.pdf http://www.jhasim.com/files/articlefiles/pdf/XASIM_Master_6_5_May_Vignette.pdf]. Accessed on: 25 April 2011.</ref>
*Watery diarrhea, abdominal pain, +/-blood per rectum.
 
Treatment:<ref name=pmid17914949>{{cite journal |author=Calderaro A, Bommezzadri S, Gorrini C, ''et al.'' |title=Infective colitis associated with human intestinal spirochetosis |journal=J. Gastroenterol. Hepatol. |volume=22 |issue=11 |pages=1772–9 |year=2007 |month=November |pmid=17914949 |doi=10.1111/j.1440-1746.2006.04606.x |url=}}</ref>
*Metronidazole.
 
===Microscopic===
Features:
*Hyperchromatic fuzz on luminal aspect of epithelial cells; at brush border.
 
DDx:
*Normal colon.
*[[Infectious colitis]] without a distinctive morphology.
 
====Images====
<gallery>
Image:Intestinal_spirochetosis_-_cropped_-_very_high_mag.jpg | Intestinal spirochetes - cropped - very high mag. (WC/Nephron)
Image:Intestinal_spirochetosis_-_very_high_mag.jpg | Intestinal spirochetes - very high mag. (WC/Nephron)
Image:Intestinal_spirochetosis_-_intermed_mag.jpg | Intestinal spirochetes - intermed. mag. (WC/Nephron)
</gallery>
www:
*[http://path.upmc.edu/cases/case391.html Intestinal spirochetosis & CMV colitis - several images (upmc.edu)].
===Special stains===
*Silver stains highlight 'em (e.g. Warthin-Starry stain).


==Amebiasis==
==Amebiasis==
*May also be spelled ''amoebiasis''.
*May also be spelled ''amoebiasis''.
===General===
{{Main|Amebiasis}}
*Infection with ''Entamoeba histolytica''.<ref>URL: [http://www.health.state.ny.us/diseases/communicable/amebiasis/fact_sheet.htm http://www.health.state.ny.us/diseases/communicable/amebiasis/fact_sheet.htm]. Accessed on: 17 June 2010.</ref>
*May mimic [[colon cancer]].<ref name=pmid19332922>{{Cite journal  | last1 = Fernandes | first1 = H. | last2 = D'Souza | first2 = CR. | last3 = Swethadri | first3 = GK. | last4 = Naik | first4 = CN. | title = Ameboma of the colon with amebic liver abscess mimicking metastatic colon cancer. | journal = Indian J Pathol Microbiol | volume = 52 | issue = 2 | pages = 228-30 | month =  | year =  | doi =  | PMID = 19332922 | url=http://www.ijpmonline.org/article.asp?issn=0377-4929;year=2009;volume=52;issue=2;spage=228;epage=230;aulast=Fernandes }}</ref>
 
May cause:<ref name=pmid20303955>{{Cite journal  | last1 = Mortimer | first1 = L. | last2 = Chadee | first2 = K. | title = The immunopathogenesis of Entamoeba histolytica. | journal = Exp Parasitol | volume =  | issue =  | pages =  | month = Mar | year = 2010 | doi = 10.1016/j.exppara.2010.03.005 | PMID = 20303955 }}</ref>
*Dysentery (diarrhea containing mucus and/or blood in the feces).
*Colitis.
*Liver abscess.
 
===Microscopic===
Features:
*Entamoeba histolytica are round/ovoid eosinophilic bodies ~ 40-60 micrometers in maximal dimension.
**Found in bowel lumen.
**Ingest [[RBC]]s.
 
====Image====
<gallery>
Image:Amebiasis_-_very_high_mag.jpg | Amebiasis - very high mag. (WC/Nephron)
Image:Amoebic_dysentery_in_colon_biopsy_%281%29.jpg | Amebiasis (WC)
</gallery>


==Cryptosporidiosis==
==Cryptosporidiosis==
Line 383: Line 264:
*[[AKA]] ''solitary rectal ulcer syndrome''.
*[[AKA]] ''solitary rectal ulcer syndrome''.
*''[[Mucosal prolapse syndrome]]'' may be used as a synonym; however, it encompasses other entities.<ref name=pmid22697798>{{Cite journal  | last1 = Abid | first1 = S. | last2 = Khawaja | first2 = A. | last3 = Bhimani | first3 = SA. | last4 = Ahmad | first4 = Z. | last5 = Hamid | first5 = S. | last6 = Jafri | first6 = W. | title = The clinical, endoscopic and histological spectrum of the solitary rectal ulcer syndrome: a single-center experience of 116 cases. | journal = BMC Gastroenterol | volume = 12 | issue =  | pages = 72 | month =  | year = 2012 | doi = 10.1186/1471-230X-12-72 | PMID = 22697798 }}</ref>
*''[[Mucosal prolapse syndrome]]'' may be used as a synonym; however, it encompasses other entities.<ref name=pmid22697798>{{Cite journal  | last1 = Abid | first1 = S. | last2 = Khawaja | first2 = A. | last3 = Bhimani | first3 = SA. | last4 = Ahmad | first4 = Z. | last5 = Hamid | first5 = S. | last6 = Jafri | first6 = W. | title = The clinical, endoscopic and histological spectrum of the solitary rectal ulcer syndrome: a single-center experience of 116 cases. | journal = BMC Gastroenterol | volume = 12 | issue =  | pages = 72 | month =  | year = 2012 | doi = 10.1186/1471-230X-12-72 | PMID = 22697798 }}</ref>
===General===
{{Main|Solitary rectal ulcer}}
*Clinically may be suspected to a malignancy - biopsied routinely.
*Mucosal ulceration.
*"Three-lies disease":<ref name=pmid18271667>{{cite journal |author=Crespo Pérez L, Moreira Vicente V, Redondo Verge C, López San Román A, Milicua Salamero JM |title=["The three-lies disease": solitary rectal ulcer syndrome] |language=Spanish; Castilian |journal=Rev Esp Enferm Dig |volume=99 |issue=11 |pages=663–6 |year=2007 |month=November |pmid=18271667 |doi= |url=http://www.grupoaran.com/mrmUpdate/lecturaPDFfromXML.asp?IdArt=459864&TO=RVN&Eng=1}}</ref>
# May not be solitary.
# May not be rectal -- can be in left colon.
# May not be ulcerating -- non-ulcerated lesions: polypoid and/or erythematous.
 
Note: Each of the words in ''solitary rectal ulcer'' is a lie.
 
====Epidemiology====
*Typically younger patients - average age of presentation ~30 years in one study.<ref name=pmid17139403>{{cite journal |author=Chong VH, Jalihal A |title=Solitary rectal ulcer syndrome: characteristics, outcomes and predictive profiles for persistent bleeding per rectum |journal=Singapore Med J |volume=47 |issue=12 |pages=1063–8 |year=2006 |month=December |pmid=17139403 |doi= |url=http://www.sma.org.sg/smj/4712/4712a7.pdf}}</ref>
*Rare.
 
====Clinical presentation====
*Usually presents as BRBPR ~ 85% of cases.<ref name=pmid17139403/>
*Abdominal pain present in approx. 1/3.<ref name=pmid17139403/>
**May be very painful.
 
Treatment:
*Usually conservative, i.e. non-surgical.
*Resection - may be done for fear of malignancy.
 
===Gross===
*Classically, anterior or anterolateral wall of the rectum.<ref name=pmid18271667/>
 
===Microscopic===
Features:<ref name=pmid18271667/><ref name=pmid2091997>{{Cite journal  | last1 = Malik | first1 = AK. | last2 = Bhaskar | first2 = KV. | last3 = Kochhar | first3 = R. | last4 = Bhasin | first4 = DK. | last5 = Singh | first5 = K. | last6 = Mehta | first6 = SK. | last7 = Datta | first7 = BN. | title = Solitary ulcer syndrome of the rectum--a histopathologic characterisation of 33 biopsies. | journal = Indian J Pathol Microbiol | volume = 33 | issue = 3 | pages = 216-20 | month = Jul | year = 1990 | doi =  | PMID = 2091997 }}</ref>
*Fibrosis of the lamina propria.
*Thickened muscularis mucosa with abnormal extension to the lumen.
*+/-Mucosa ulceration.
*+/-Submucosal fibrosis.
 
DDx:
*[[Inflammatory pseudopolyp]] (inflammatory polyp).
**Associated with [[inflammatory bowel disease]].
*[[Rectal prolapse]].
*Well-differentiated [[colonic adenocarcinoma|adenocarcinoma]].
 
===IHC===
*p53 -ve.
**May be used to help exclude adenocarcinoma.


==Rectal prolapse==
==Rectal prolapse==
Line 452: Line 292:


==Angiodysplasia==
==Angiodysplasia==
===General===
{{Main|Angiodysplasia}}
*Causes (lower) GI haemorrhage.
*Generally, not a problem pathologists see.
*May be associated with [[aortic stenosis]]; known as ''Heyde syndrome''.<ref name=pmid19652242>{{cite journal |author=Hui YT, Lam WM, Fong NM, Yuen PK, Lam JT |title=Heyde's syndrome: diagnosis and management by the novel single-balloon enteroscopy |journal=Hong Kong Med J |volume=15 |issue=4 |pages=301–3 |year=2009 |month=August |pmid=19652242 |doi= |url=http://www.hkmj.org/abstracts/v15n4/301.htm}}</ref>
 
Epidemiology:
*Older people.
 
Etiology:
*Thought to be caused by the higher wall tension of cecum (due to larger diameter) and result from (intermittent) venous occlusion/focal dilation of vessels.<ref name=Ref_PBoD854>{{Ref PBoD|854}}</ref>
 
===Gross===
*Cecum - classic location.
 
Note:
*[[Crohn's disease]] - may mimic angiodysplasia radiographically.<ref name=pmid3054852/>
 
===Microscopic===
Features:<ref name=pmid3054852>{{Cite journal  | last1 = Hemingway | first1 = AP. | title = Angiodysplasia: current concepts. | journal = Postgrad Med J | volume = 64 | issue = 750 | pages = 259-63 | month = Apr | year = 1988 | doi =  | PMID = 3054852 }}</ref>
*Dilated vessels in mucosa and submucosa.


==Drugs==
==Drugs==
Line 560: Line 381:
*[[Intestinal polyps]].
*[[Intestinal polyps]].
*[[Small bowel]].
*[[Small bowel]].
*[[Doughnuts]].


=References=
=References=
Michael
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