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Roy N. Barnett, MD
Westport, Conn

JAMA. 1985;253(16):2363.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

I would like to comment on Dr Fenoglio's answer to the query about routine examination of hemorrhoidal tissue.¹ Dr MacLeod asked about the cost-effectiveness of routine microscopic examination, and I don't believe he got a satisfactory answer.

It certainly is possible to find abnormalities in any portion of tissue removed for any reason, but this does not prove the cost-effectiveness of the procedure. The examples quoted in the answer include several entities whose recognition is minimally important (carcinoma in situ, condyloma, and rectal carcinoid) or should have been recognized as lesions by the surgeon grossly. The operator, who has a much better view of the fresh lesion, may well recognize a gross abnormality. The pathologist, faced with a wrinkled fixed specimen, frequently in multiple parts, may by luck hit the lesion in a random mid-sagittal section but also may not.

I simply don't believe that the . . . [Full Text PDF of this Article]

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