Gynae dataset Flashcards
Cervix macro - LLETZ
Measure Ink Slice and examine Embed all single piece, single cassette
Cervix macro - hysterectomy
measure (specimen & tumour)
vaginal tissue = surgical resection margin
position of tumour should be recorded
need max depth of invasion Margin - vaginal, bladder, rectum, parametrium If no visible tumour - entire cervix 1block/cm Uterus + ovaries rep section
Cervix micro
Tumour type - Adeno, SCC, AdenoSq, NET Grade Size - depth and diameter LVSI Margins Stage - FIGO
Small Bx
Number of pieces + size
Squamocolumnar junction and intact surface epithelium
Needs to mention - adequacy (ecto/endo/transformation zone)
CIN/CGIN
Koilocytosis
Uterus macro
Opening - bisect specimen Blocks Tumour x4 with full thickness of wall LUS x1 Cornu Parametrium Cervix Ovaries and tubes Omentum - 2 to 4 sections Lymph nodes All other biopsies
Uterus micro & staging
Prognosis: Serous, Clear cell, Carcisarcoma, Undifferentiated Tumour grade: G1 - G3 Endometrioid Myometrial invasion (arcuate plexus 50%) - IB LVSI Cervical stromal invasion -II Vaginal involvement - IIIB Uterine serosa involvement - IIIA Parametrial involvement - IIIB Adnexal involvement IIIA Lymph nodes pelvic (IIIC1), paraaortic (IIIC2) Omental - IVB Peritoneal - IVB background endometrium
Ovarian macro
Open + ink if needed weight Intact vs capsular breach 1cm interval sections 1 block/cm any heterogenous area uterus - as per benign Omentun - 4-6 appendix - embed entirely
Ovarian micro and staging
Tumour type: serous, endometrioid, clear cell, mucinous Grade - HGSC (>13/10HPF + necrosis) Microinvasion - <5mm LN status - IIIC Peritoneal bx - IIIA (micro), IIIB (macro) Omentum - >2cm then IIIC Peritoneal washings -IC Fallopian tubes -IIA
Uterine sarcoma core item
Macroscopic sie Tumour circumscription Tumour type - leiomyosarcoma, stromal sarcoma, adenosarcoma depth of myometrium invasion/sarcomatous overgrowth (for adenosarcoma) mitotic count /10HPF serosal involvement Tumour free distance to serosa cervical/parametrial involvement LVSI adnexal involvement LNs Peritoneal washings, pelvic tissue, omentum
Vulva macro
Size of specimen and tumour Unifocal vs multifocal Distance to the margins Background skin Block tumour and margins Any other abnormality
Vulva micro
Type - SCC, BCC Differentiation/Grade Max tumour size Max tumour depth Depth of invasion (from normal mucosa) LVSI LN involvement Margini status uVIN or dVIN
Benign - Manchester repair
uterine prolapse - cervix & vaginal wall
Measure specimen
Describe surface etc
Cervix - anterior and posterior lip with vaginal wall
Benign uterus
Measure specimen Describe the surface Photograph if medico legal case (obstetrics) Endometrial thickness Polyps Fibroid - size and location
Uterus blocks
Cervix x2
Endometrium x2
Abnormality
Fibroid x2 random sampling
If morcellated - endo and serosal surface
If obstetrics - fresh caesarean scar, traumatic rupture
Placental site
Myomectomy specimen
Measure size and numbers
weight
One to three block per fibroid
if abnormal 1cm/block
