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GI Tract |
Mucosal Polypectomy |
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Guideline & Procedure:- Differential diagnoses: adenoma, adenocarcinoma, inflammatory polyp, hamartomatous polyp.
- For an intact polyp, identify and ink the resection margin or stalk if identifiable.
- Photograph any specimen if >5cm in the greatest diameter.
- Allow the specimen to fix in formalin (or Bouin’s fixative if available) for several hours.
- Measure the polyp head in three dimensions and measure the length and diameter of the stalk if present.
- Describe the external surface of the polyp (sessile vs. pedunculated, color, texture of surface mucosa, ulceration).
- For polyps with no stalk or a stalk less than 1 cm in length, cut in half longitudinally so that each half includes both polyp and stalk with resection margin. Continue to serially section at 3 mm intervals in the same plane of sectioning, if necessary.
- For polyps with a stalk 1 cm or more in length, take a cross section of the base. Then cut the polyp and stalk longitudinally so that each half includes both polyp and stalk. Continue to serially section the head at 3 mm intervals in the same plane of sectioning, if necessary.
- Describe the cut surface of the head and the stalk (color, solid vs. cystic) , examine for any evidence of invasion.
- For polyps in multiple pieces, serially section tissue and examine for hard white areas or necrosis.
Suggested Sections for Histology: