Neoplastic Intestinal Disease

Abstract

Polyps of the gastrointestinal tract are usually removed endoscopically by a single incision at the base of the polyp stalk. Although these specimens lack the size and complexity of more extended bowel resections, they are delicate structures that require meticulous processing. First, obtain relevant clinical information such as the patient’s history, the endoscopic findings, and the anatomic site from which the polyp was removed. Next, turn your attention to the specimen itself. The polypectomy specimen poses three important questions to the surgical pathologist: (1) Are adenomatous changes present? (2) Is infiltrating carcinoma present, and if it is does it infiltrate into the stalk? (3) Do any of the neoplastic changes extend to the resection margin at the base of the stalk? Clearly, the polypectomy specimen must be carefully oriented and processed so that these issues can be addressed.