Difference between revisions of "Hemorrhoid"

From Libre Pathology
Jump to navigation Jump to search
Line 58: Line 58:
**[[Arteriovenous malformation]] - has large arteries.
**[[Arteriovenous malformation]] - has large arteries.


Image:
===Image===
<gallery>
Image: Hemorrhoid -- very low mag.jpg | Hemorrhoid - very low mag. (WC)
Image: Hemorrhoid -- low mag.jpg | Hemorrhoid - low mag. (WC)
Image: Hemorrhoid - alt -- low mag.jpg | Hemorrhoid - low mag. (WC)
Image: Hemorrhoid -- intermed mag.jpg | Hemorrhoid - intermed. mag. (WC)
</gallery>
www:
*[http://www.profimedia.si/picture/longitudinal-section-of-human-rectum-hemorrhoid-tissue/0039860546/ Hemorrhoids (profimedia.si)].
*[http://www.profimedia.si/picture/longitudinal-section-of-human-rectum-hemorrhoid-tissue/0039860546/ Hemorrhoids (profimedia.si)].



Revision as of 01:40, 20 December 2013

Hemorrhoid
Diagnosis in short

Hemorrhoid. H&E stain.

LM polypoid lesion (epithelium on three sides) with large dilated veins and thick-walled vessels +/- fibrin thrombi, +/-edema, covered by squamous epithelium +/- keratinization and/or columnar epithelium
LM DDx fibroepithelial polyp, vascular lesions
Site rectum/anus

Signs +/-bright red blood per rectum
Symptoms +/-itching, +/-pain
Prevalence very common
Prognosis benign
Clin. DDx other causes of rectal bleeding, e.g. colorectal carcinoma

Hemorrhoid is a benign pathology of the rectal venous plexus, that may mimic more serious pathology, i.e. cancer.

General

  • Benign.

Clinical features:[1]

  • Bright red blood per rectum (BRBPR).
  • Pain.
  • Itching.
  • Prolapse.

Gross

Features:[2]

  • Grey mucosa.
  • Pale or purple stroma.

Microscopic

Features:[2]

  • 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:

Image

www:

Sign out

ANAL LESION, REMOVAL:
- HEMORRHOID.
HEMORRHOIDS, EXCISION: 
- HEMORRHOIDS.

Micro

The sections show rectal and anal mucosa, and a submucosa with prominent blood vessels in a fibrotic stroma. The rectal mucosa has focal reactive nuclear changes and evidence of prior erosions. The anal mucosa is unremarkable.

Anal mucosa only

The sections show anal mucosa, and submucosa with prominent blood vessels in a fibrotic stroma. The anal mucosa is unremarkable.

See also

References

  1. 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.
  2. 2.0 2.1 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.