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Essentials of macroscopic evaluation of specimens from gastrointestinal tract
  1. Monika Vyas1,
  2. Dipti M Karamchandani2
  1. 1 Department of Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
  2. 2 Department of Pathology, Division of Anatomic Pathology, UT Southwestern Medical School, Dallas, Texas, USA
  1. Correspondence to Dr Dipti M Karamchandani, Department of Pathology, Division of Anatomic Pathology, UT Southwestern Medical School, Dallas, TX 75390, USA; Dipti.Karamchandani{at}


An astute macroscopic examination, coupled with correlating the gross findings with clinical indication and operative notes along with judicious, yet all pertinent sectioning for pathological examination is crucial for an accurate histopathological diagnosis, eventually leading to optimal patient care. This succinct review highlights the general concepts that lay the foundation of evaluating and grossing specimens from the luminal gastrointestinal (GI) tract. We also discuss the gross evaluation and sectioning of small therapeutic resections, along with a systematic approach and rationale when grossing and submitting histological sections from larger oncological resections from the luminal GI tract. Selected site-specific considerations, for example, grossing treated rectal and oesophageal cancers or taking sections from mucinous tumours of the appendix, among others, are also discussed.

  • gastrointestinal neoplasms
  • gastrointestinal diseases
  • esophagus

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  • Handling editor Runjan Chetty.

  • Contributors MV wrote the first version of the paper. DMK did significant edits and additions to the paper and critically revised the paper for intellectual content. Both authors worked on the figures together. Both authors have approved the final version of the manuscript and can take public responsibility for the content of this paper.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; externally peer reviewed.