Smalls Flashcards
always include this before describing a specimen
weight
appendix CPT code
88304
palpating the LLQ increases RLQ pain
Rovsing’s sign
fibrinous, adhesions descriptor
shaggy
________ symptoms are more severe in appendicitis
acute
if this is identified in the appendix, submit the entire specimen
mucin
neuroendocrine enterochromaffinandenteroglucagon cellsnormally found in the lamina propria
carcinoid tumor
High grade appendiceal mucinous neoplasm (HAMN) shows
increased nuclear atypia
usually bilateral, large multinodular tumors of metastatic origin involving the ovaries with primary sites in the GI tract (appendix); signet ring cell appearance histologically
Krukenberg tumors
gallbladder doesnt empty properly
biliary dyskinesia
gallstones have moved to the common bile duct causing blockage that doesn’t allow the gallbladder or rest of the biliary tree to drain
choledocholithasis
gallstones
cholelithiasis
inflammation often due to bile sludge
cholecystitis
hepatic resection margin
adventitia
you are at risk of gallstones if you have rapid weight loss on a
crash or starvation diet
gallstones form because
cholesterol or bilirubin in the bile is high
pigment stones (bilirubin) form most often in people with these diseases
liver disease or blood disease
residual bile may also promote the formation of these
gallstones
gallstones cpt code
88304
this gallbladder lesion increases risk of carcinoma
porcelain gallbladder
porcelain gallbladder occurs because of
chronic cholecystitis
sentinel lymph node of the gallbladder (periductal)
Lund’s or Mascagni’s LN
the periductal lymph node of gallbladder is a
pertinent negative
describe the gallbladder from the ________ in
outside
this margin is usually not described unless there is a tumor or defect on the surface
adventitia/hepatic soft tissue margin
routine sections of gallbladder (5)
-cystic duct
-periductal lymph node
-perpendicular neck to margin
-neck
-fundus
if there is a polyp/mass/palpable lesion in a gallbladder, you must
submit all and ink the cystic duct margin and hepatic soft tissue margin
gallbladder cpt code
88304
gallbladder staging is based on
invasion
for local/segmental biliary resections, remove all _____ ________ and submit them separately, each in their own cassette en face
duct margins
do not open local/segmental biliary resections ____________ or you may dislodge a papillary lesion, rather, do this
longitudinally; serially cross section ducts
removing prostate tissue in small fragments via a resectoscope
transurethral resection of prostate
what must you do with TURP specimens (3)
weigh them, measure in aggregate, and separate any calculi
TURP cpt code
88305
do you submit TURP calculi for chemical analysis
no unless requested
are bladder calculi submitted
no
TURBT cpt code
88307
done to remove superficial bladder cancer
TURBT
do you weigh a TURBT specimen
no
TURBT is ________ submitted
entirely
tonsils cpt code in younger patients
88300
tonsils cpt code in older patients
88304
one section of tonsils are submitted for two conditions
tonsilitis or pharyngitis
all tonsil tissue is submitted if there is a history of (3)
head and neck cancer, cervical lymphadenopathy, neck mass
inking tonsils is dependent on
history
if there is a history of SCC, you should do this with the tonsils
ink them
if a tonsil specimen is to rule out lymphoma, what should you do
section superficially with a sterile kit before inking
gross examination of tissue in the OR, no frozen performed just sectioning and evaluating
88329
most common salivary gland for a tumor
parotid
most common salivary gland for a malignant tumor
sublingual
pathologies of salivary glands (3)
-sialadenitis
-sialolithiasis
-neoplasm
most common component of sialoliths (99%)
carbonate apatite
sialoliths are mainly composed of
inorganic material
most common benign salivary neoplasm
pleomorphic adenoma
second most common salivary benign neoplasm
Warthin’s tumor (papillary cystadenoma lymphomatosum)
main tumor in parotid gland
pleomorphic adenoma
most common malignancy of salivary glands
mucoepidermoid carcinoma
present as a slow-growing painless mass
low grade mucoepidermoid carcinoma
present as a rapidly growing painful mass
high grade mucoepidermoid carcinoma
major risk factor for development of malignant salivary tumors
tobacco use
low grade malignancies of the salivary glands (2)
acinic cell carcinoma, epithelial-myoepithelial carcinoma
inflammation of the salivary glands
sialadenitis
most common salivary gland tumor in infants/children
hemangioma
90% of salivary gland hemangiomas arise within the
parotid gland
salivary gland CPT code
88307
sialolith CPT code
88307
most common received salivary gland
parotid gland
what should you always look for in a salivary gland specimen
nerves (facial nerve)
sinus CPT code
88304
salivary gland staging is dependent on (2)
-tumor size
-extension/invasion
this type of sinus specimen is gross only
deviated septum
what should you do for a sinus specimen that has a clinical history of known or suspected sinonasal papilloma
submit the entire specimen for carcinoma evaluation
most common nasal papilloma
inverted papilloma
all nasal papillomas should be
completely excised
bone biopsy CPT code
88307
lipoma CPT code
88304
a condition that causes benign tumors to form
Gardner syndrome
a condition marked by the growth of lipomas most commonly in overweight or obese women
adiposis dolorosa
a hereditary condition that causes multiple lipomas to form particularly in the trunk and extremities
Familial multiple lipomatosis
Herniated fat that appears to originate from the retroperitoneal fat outside and posterior to the internal spermatic fascia and protrudes through the internal ring lateral to the cord
lipoma of cord
most common types of hernias (4)
-inguinal
-incisional
-femoral
-umbilical
most common hernia in women, especially in pregnant or obese
femoral
common hernia in newborns, obese women, or multiparous women
umbilical
most common hernia in elderly oroverweightpeople who are inactive after abdominal surgery
inguinal
combination of pressure and an opening or weakness of muscle or fascia; the pressure pushes an organ or tissue through the opening or weak spot
hernia
four risk factors for hernias
-diarrhea
-constipation
-persistent cough
-persistent sneezing
hernia mesh gross only cpt code
88300
hernia tissue cpt code
88302
hydrocele cpt code
88302
spermatocele cpt code
88304
cyst CPT code
88304
intervertebral disk cpt code
88304
bone marrow biopsies are typically taken from this
iliac crest
if a lawsuit is suspected for a mesh hernia specimen, what should you do
photograph the specimen
for a hernia mesh specimen, do you submit the mesh?
no, dissect the soft tissue off
cysts that form in the tubules leading to the testis
spermatocele
collections of clear fluid that form between the layers of tissue surrounding the testis (tunica vaginalis)
hydrocele
spermatic or epididymal cyst
spermatocele
this is a common specimen after a herniation or prolapse occurs
intervertebral disk
often submitted for phimosis
foreskin
foreskin in non-newborns cpt code
88304
foreskin tissue cpt code
88302
foreskin gross only cpt code
88300
hemorrhoids CPT code
88304
dilated veins that can be internal or external
hemorrhoids
caused by chronic constipation, chronic diarrhea, pregnancy, portal HTN
hemorrhoids
joint mice
joint, loose body
joint cpt code
88304
chondrocytes die causing full thickness portions of cartilage to slough into the joint, forming loose bodies
osteoarthritis
most common manifestation of osteoarthritis or severe degenerative disease
joint loose bodies
anal skin tag CPT code
88304
vulvar skin tag
88305
one of the most common cutaneous lesions
fibroepithelial polyp
heart valve CPT code
88305
valve doesn’t close properly and the valve leaks
regurgitation
valve folds back into atrium and. causes regurgitation
prolapse
valve gets thickened and may fuse together, causing narrowing
stenosis
valve is not formed
atresia
vegetations on a heart valve may be indicative of
infective endocarditis
these are primary submitted for stenosis or insufficiency
aortic valves
a bicuspid aortic valve is a
congenital defect
what should you describe when assessing calcifications suggestive of rheumatic heart disease
-% of valve involved with calcifications
-extent of calcifications (from aortic root to within __cm to free edge or just to the free edge)
primarily submitted for prolapse, regurgitation, insufficiency
mitral/tricuspid valves
this valve is prone to vegetations
mitral valve
this type of change is usually noted in mitral and tricuspid valves
myxoid change
transplant from the same species (2)
homograph, allograph
transplant from one species to another species (2)
heterograph, xenograft
transplant form the same body from one part to another part
autograph
ball and cage, Starr-Edwards type of mechanical prosthetic valve
high profile
disk-harken, Hinged leaflet (gott-daggett), central flow (bjork-shiley) type of mechanical prosthetic valve
low profile
prosthetic heart valve cpt code
88300
granulation tissue
pannus
what should you state about the prosthetic heart valve
if it is mechanical or bioprosthetic
