The only way colorectal cancer can officially be diagnosed is by a pathologist. When symptoms suggesting colorectal cancer emerge, your doctor will typically run different diagnostic tests, such as a colonoscopy, to get a better understanding for what is causing the symptoms. Colonoscopies (the most widely utilized form of endoscopic biopsy for colorectal cancer) and many other diagnostic tests allow the doctor to visually examine the colon and rectum for abnormalities and also extract tissue for eventual pathologic testing.

Once the tissue is extracted, it is sent to a pathologist who will determine whether or not any cancerous cells exist within the tissue sample. Ultimately, the results and diagnosis are assembled in what’s known as a pathology report. Here’s a breakdown of the most important sections of your pathology report, according to the Abramson Cancer Center of the University of Pennsylvania.

The Gross Description

This section essentially  is a description of what the pathologist saw by examining the tissue sample without any microscopic aid.


This section may also be called microscopic diagnosis and is a pivotal section. If a positive diagnosis is made, the type of cell the tumor came from will be described here. It should be noted that nearly all colorectal cancer tumors originate in glandular cells inside the colon. Cancers from these types of cells are known as adenocarcinomas, and they account for almost 98 percent of colorectal cancers. If any polyps were removed during the biopsy, they will also be described here. The most common types of polyps are adenomatous polyps, villous polyps, hyperplastic polyps and pseudopolyps.

Histologic Grade

In this section of the pathology report, the cells of the tumor will be graded on how much they look like normal cells. When a normal cell differentiates, it undergoes certain changes and becomes a specific type of cell. A grade of 1 here means the cells appear relatively normal; a grade of 3 means the cells appear fairly abnormal and consequently may grow rapidly.

Depth of Invasion

This section describes how far the tumor spread into surrounding tissues. Typically, the description will use scientific terminology and can be a little confusing, so be sure to discuss this section of the report with your doctor to better understand the layers of the colon your cancer has invaded.

Lymphovascular Invasion and Lymph Nodes

These two sections describe the findings on whether cells from the tumor have spread to surrounding areas, and perhaps beyond. Colon cancer cells typically use the lymph nodes as the first avenue of metastasizing or spreading. These lymph nodes may be able to be removed during colon cancer surgeries.

The pathologist uses these cumulative findings to diagnose the colon cancer and the specific stage it has reached, which in turn dictates what treatment options are most viable.

If you or a loved one has been diagnosed with colorectal cancer in Georgia and feel a delayed diagnosis of the disease was caused by your doctor’s error, contact an experienced Atlanta medical malpractice and colorectal cancer lawyer at the Dover Law Firm at 770-518-1133 to schedule a no-charge consultation. You can also request a copy of our free book, I Have Cancer…Should It Have Been Caught Earlier?, as well as a copy of our free report, Colon and Rectal Cancers: The Risks, the Signs, Diagnosis and Treatment.