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Hemorrhoids — is a pathomorphological study of fragments of cavernous tissue and mucous membrane of the anal canal removed during hemorrhoidectomy. Code PG061 provides for microscopic analysis of dilated vascular plexuses. Although hemorrhoids are a common vascular disease, histological examination of the removed material is a mandatory medical standard to confirm the diagnosis and exclude concomitant pathologies, in particular hidden tumors of the rectum.

Research objective: The main task is to verify structural changes in the vessels and connective tissue. The pathologist must confirm the presence of varicose cavernous bodies and assess the presence of complications such as thrombosis or necrosis. A separate critical task is to check the mucosa for signs of malignancy (cancer), which can clinically mimic a common hemorrhoid.

What does the pathologist evaluate:

Condition of vascular walls: detection of dilated thin-walled veins and cavernous sinuses with signs of sclerosis.
Presence of thrombosis: fixation of fresh or organized thrombi in the lumen of the nodes, which explains the pain syndrome.
Epithelial changes: looking for signs of metaplasia, dysplasia, or ulceration of the mucosa.
Inflammatory infiltration: assessment of the degree of chronic or acute inflammation in the surrounding tissues.
Condition of the fibromuscular framework: analysis of Parkes's ligament degeneration, which leads to node loss.

Clinical significance: The conclusion with the code PG061 allows the proctologist to finally be convinced of the benignity of the process. The detection of specific changes (for example, signs of Crohn's disease, villous tumors or squamous cell carcinoma) radically changes the further tactics of treatment and monitoring of the patient. Histological confirmation of thrombosis or necrosis justifies the radicality of the intervention performed.

When is it prescribed:

after surgical removal of internal or external hemorrhoids (hemorrhoidectomy);
if thrombosis or entrapment of hemorrhoids with necrosis is suspected;
if hemorrhoids are combined with other formations of the anal canal (polyps, papillomas);
for differential diagnosis with mucosal prolapse or rectal neoplasms.