![]() ![]() 5 The potential delay in diagnosis, low negative predictive value and purported increased costs are cited as arguments for resection without confirmation if the clinical diagnosis in straightforward. 4 Preoperative biopsy of mass lesions in resectable patients, however, is more controversial. Indications for fine needle aspiration (FNA)įNA is a well-established technique to procure tissue for diagnosis in patients with unresectable disease and in those patients who may be eligible for therapeutic protocols. Modern imaging techniques such as high-resolution spiral computed tomography (CT), magnetic resonance imaging and endoscopic ultrasound (EUS) have improved our ability to recognise and delineate pancreatic masses and to detect them earlier as smaller mass lesions. 3 Although the vast majority (80–90%) of tumours in the pancreas are conventional ductal adenocarcinomas, there is a wide variety of non-neoplastic, benign neoplastic and malignant solid and cystic lesions in the pancreas that are analysed preoperatively for diagnosis. 2 Age, male gender, obesity, cigarette smoking and genetic conditions such as familial pancreatitis, Peutz–Jegher’s syndrome and familial adenomatous multiple mole melanoma syndrome are associated with an increased risk of pancreatic cancer. 1 The incidence of pancreatic cancer is relatively uniform among different countries and has a peak incidence in the seventh to eighth decades of life. The specimen is serially sectioned radially clockwise from 12:00 and entirely submitted in _ cassettes.Pancreatic cancer causes over 200 000 deaths per year and is the eighth leading cause of cancer deaths worldwide. The endocervical margin is inked blue and the ectocervical and stromal margins are inked black. The ectocervical mucosa is white / tan-pink and smooth with focal granularity. Received in formalin, labeled with patient name, medical record number and “cervix”, is a 0.5-cm thick LEEP specimen with a central _ x _ cm slit-like os surrounded by a complete _ cm rim of cervix with a suture marking the 12 o ’ clock position. #_ & #_ = _ to _ o'clock, _ fragments each. A total of _ radial serial sections are entirely submitted in clockwise order in 6 cassettes as follows. _ to _ cm in diameter mucin-filled cysts / polyps are present. The endocervical mucosal is pink tan/focally erroded. The transition zone is well-defined/irregular with hemorrhage/ulceration. There ectocervical surface is white/pink with superficial errosions at _ o'clock position. Received in formalin, labeled with patient name, medical record number and “cervix”, is a _ cm long cervical cone, with a _ to _ cm diameter, marked at _ o'clock position by a suture. Fragmented specimens should be sectioned perpendicularly to the mucosal surface, in a manner similar to that described above for cones.It is critical to submit all of the mucosa in this manner however, in very large specimens, excess stroma may be trimmed and submitted separately. Each section should resemble a wedge of pie. a lesion or sharp angle in the tissue), if possible, and mention this in your dictation. If there is no orientation, start at an anatomic landmark (e.g. Section the cone in a radial, clockwise fashion, beginning at the 12 o ’ clock position.If you cannot determine the margins on a fragmented specimen, ask a staff pathologist for help. tip of the endocervical canal) should be inked with a different color than the rest of the margin. Describe the overall tissue (color, shape, fragmentation) and os (diameter, shape), as well as any lesions (ulcer, mass, hemorrhage, defect, cyst, laceration include measurements of lesions).Measure (3 dimensions) each individual piece of a fragmented specimen. Measure cones in 3 dimensions, including the surface diameter of the ectocervix (cm x cm) and depth (from the ectocervix to the endocervical margin).Fragmented specimens are usually unoriented. Under optimal circumstances, cones are oriented, usually with a suture marking the 12 o ’ clock position. The speciment may be in the shape of a cone (with the point of the cone pointing to the endometrial cavity) or in fragments. ![]() The vast majority of LEEP is performed for high-grade cervical dysplasia. ![]()
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