nodes. They should be submitted for histologic examination for unsuspected lymphoma, leukemia or other pathology. Neoplasitc conditions: Small tumors can be submitted entirely. Large tumors should be sampled to demonstrate tumor type, margins, involvement of contiguous structures. Section of uninvolved gland. Lymph nodes, if present. Indicate margins with ink; margins are generally important in salivary gland lesions. TONSILS and ADENOIDS Specimen Type: TONSILLECTOMY/ ADENOIDECTOMY Gross Template: Labeled with the patient’s name (last name, first name), medical record number (#), designated “[***]”, and received [fresh/in formalin] is a [***gram], [***x***x***cm] [tonsillectomy/adenoidectomy]. Sectioning reveals [tan, smooth, homogenous cut surfaces with cryptic architecture]. Representative sections are submitted [describe cassette submission]. Cassette Submission: 1 cassette with representative cross section(s) THYMUS Specimen Type: RESECTION (partial/total thymectomy) Gross Template: Labeled with the patient’s name (last name, first name), medical record number (#), designated “[***]”, and received [fresh/in formalin] is a [***gram], [***x***x***cm] [partial/total] thymectomy. [Describe orientation if provided]. Sectioning reveals [describe any lesions present including size, color, external appearance, relationship to capsule, calcification, necrosis, relationship to uninvolved thymus]. The remaining cut surfaces are [yellow, smooth, lobulated, fatty, unremarkable]. The adherent adipose tissue is dissected through for lymph nodes. [Describe number/size of lymph nodes identified]. Representative sections are submitted [describe cassette submission]. Ink Key: Black- external surface (if unoriented and for tumor) [Additional ink may be required if oriented for margin assement] Cassette Submission: 10-12 cassettes One cassette if incidentally removed One cassette per 1 cm of lesion/tumor
Specimen Type: TOTAL LARYNGECTOMY Procedure: Orient specimen and determine structures present If radical neck dissection present, remove from larynx and process as described in the manual Preserve soft tissue relationships if tumor is grossly involving the organ May remove thyroid if present and uninvolved Ink the external soft tissue, avoid inking over mucosa Black- right Blue- left 3. Remove inferior tracheal ring (marin) 4. Open along the posterior midline (may need to crack cartilage) and prop open and fix overnight 5. Photograph 6. Describe mucosa and presences of lesion(s)/ulcerations a. Indicate location of lesion -supraglottic: (extends from the tip of epiglottis to the apex of ventricle and includes the epiglottis, aryepiglottic folds, arytenoids, false vocal cords, and the ventricle) -glottic: (extends from the ventricle to 0.5-1.0 cm below the true vocal cord and includes the anterior and posterior commissures) -subglottic: (extends from 1.0 cm below the true vocal cord to inferior rim of the cricoid cartilage) -transglottic * note if lesion crosses the midline b. Indicate extent of lesion: document if lesion involves base of tongue, epiglottis, piriform sinus, aryepiglottic folds, arytenoid mucosa, anterior and posterior midlines, hyoid bone, thyroid, cartilage (thyroid and/or cricoid), strap muscles, and involvement of any additional tissue/organs present 7. Shave the mucosal margins 8. Section along anterior midline and photograph cut surface 9. Document maximum thickness of lesion and distance to all margins - superior epiglottis - inferior tracheal ring - right and left lateral inked soft tissue - anterior and posterior inked soft tissue - superior inked soft tissue (base of tongue)