Handling and Pathology Reporting of Gastrointestinal Endoscopic Mucosal Resection

Area of Science:

• Gastroenterology
• Pathology
• Surgical Oncology

Background:

• Endoscopic mucosal resection (EMR) is a minimally invasive endoscopic technique for early gastrointestinal (GI) lesion removal.
• EMR offers a surgical alternative, preserving tissue for critical histopathological analysis.
• Accurate pathological assessment of EMR specimens is vital for determining metastasis risk and lymph node involvement.

Purpose of the Study:

• To emphasize the critical role of pathologists in the management of endoscopic mucosal resection (EMR) specimens.
• To outline the essential steps in grossing and reporting EMR specimens for optimal diagnostic yield.
• To highlight the importance of detailed pathological information for patient treatment and prognosis.

Main Methods:

• Literature search of PubMed and Google Scholar using the term "endoscopic mucosal resection."
• Review of publications focusing on the responsibilities of pathologists in handling EMR specimens.
• Synthesis of current best practices for gross examination and reporting of EMR samples.

Main Results:

• EMR specimen handling requires precise orientation, margin inking, and accurate fixation.
• Pathological reports must detail diagnosis, grade, invasion depth, margin status, and lymphovascular invasion.
• Standardized pathological evaluation of EMR specimens is essential for predicting patient outcomes.

Conclusions:

• Pathologists play a pivotal role in the accurate interpretation of EMR specimens.
• Adherence to standardized protocols for specimen handling and reporting enhances diagnostic accuracy.
• Comprehensive pathological evaluation of EMR specimens is indispensable for guiding patient management and prognosis.