Common Sense Reporting of Colorectal Adenocarcinoma in Endoscopically Obtained Samples

Some authors recommend including numerous histologic prognostic features when reporting colorectal carcinomas detected in endoscopic specimens. Unfortunately, data regarding their utility in polypectomy specimens (1) are mostly derived from experience with surgical specimens, (2) provide incremental information, and/or (3) are more accurate when provided by the physician who removed the lesion than the surgical pathologist. Reporting biopsy samples of clinically malignant tumors as "at least high-grade dysplasia/intramucosal carcinoma" does not accurately portray biologic risk. This article provides the reader with evidence-based practice points that limit the complexity of pathology reports while still providing sufficient information to guide patient management.