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Difference between revisions of "Hemorrhoid"
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| Micro = 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 | | Micro = 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 | ||
| Subtypes = | | Subtypes = | ||
| LMDDx = [[fibroepithelial polyp]], vascular lesions | | LMDDx = [[fibroepithelial polyp]], vascular lesions (e.g. [[Kaposi sarcoma]]) | ||
| Stains = | | Stains = | ||
| IHC = | | IHC = | ||
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| Prognosis = benign | | Prognosis = benign | ||
| Other = | | Other = | ||
| ClinDDx = other causes of rectal bleeding | | ClinDDx = other causes of rectal bleeding (e.g. [[colorectal carcinoma]]), [[malignant melanoma]] | ||
}} | }} | ||
'''Hemorrhoid''' is a benign pathology of the rectal venous plexus, that may mimic more serious pathology, i.e. [[cancer]]. | '''Hemorrhoid''' is a benign pathology of the rectal venous plexus, that may mimic more serious pathology, i.e. [[cancer]]. | ||
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Clinical features:<ref>{{Cite journal | last1 = Cazemier | first1 = M. | last2 = Felt-Bersma | first2 = RJ. | last3 = Cuesta | first3 = MA. | last4 = Mulder | first4 = CJ. | title = Elastic band ligation of hemorrhoids: flexible gastroscope or rigid proctoscope? | journal = World J Gastroenterol | volume = 13 | issue = 4 | pages = 585-7 | month = Jan | year = 2007 | doi = | PMID = 17278225 }}</ref> | Clinical features:<ref>{{Cite journal | last1 = Cazemier | first1 = M. | last2 = Felt-Bersma | first2 = RJ. | last3 = Cuesta | first3 = MA. | last4 = Mulder | first4 = CJ. | title = Elastic band ligation of hemorrhoids: flexible gastroscope or rigid proctoscope? | journal = World J Gastroenterol | volume = 13 | issue = 4 | pages = 585-7 | month = Jan | year = 2007 | doi = | PMID = 17278225 }}</ref> | ||
*Bright red blood per rectum (BRBPR). | *[[Bright red blood per rectum]] (BRBPR). | ||
*Pain. | *Pain. | ||
*Itching. | *Itching. | ||
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*Pale or purple stroma. | *Pale or purple stroma. | ||
===Microscopic | DDx - clinical: | ||
*[[Malignant melanoma]].<ref name=pmid11592745>{{Cite journal | last1 = Felz | first1 = MW. | last2 = Winburn | first2 = GB. | last3 = Kallab | first3 = AM. | last4 = Lee | first4 = JR. | title = Anal melanoma: an aggressive malignancy masquerading as hemorrhoids. | journal = South Med J | volume = 94 | issue = 9 | pages = 880-5 | month = Sep | year = 2001 | doi = | PMID = 11592745 }} | |||
</ref> | |||
==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: | ||
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**[[Angiosarcoma]]. | **[[Angiosarcoma]]. | ||
**[[Arteriovenous malformation]] - has large arteries. | **[[Arteriovenous malformation]] - has large arteries. | ||
*[[Mucosal prolapse]]. | |||
===Image=== | ===Image=== | ||
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HEMORRHOIDS, EXCISION: | HEMORRHOIDS, EXCISION: | ||
- HEMORRHOIDS. | - HEMORRHOIDS. | ||
</pre> | |||
===Alternate=== | |||
<pre> | |||
"EXTERNAL HEMORRHOID", EXCISION: | |||
- POLYPOID FRAGMENTS OF RECTAL-TYPE MUCOSA WITH REACTIVE CHANGES, ULCERATION, SMOOTH | |||
MUSCLE HYPERPLASIA, AND GRANULATION TISSUE WITH INTERMEDIATE SIZE BLOOD VESSELS. | |||
- NEGATIVE FOR DYSPLASIA. | |||
</pre> | </pre> | ||