Liver & intrahepatic bile ducts
General
Grossing, frozen section & features to report


Topic Completed: 1 February 2012

Minor changes: 1 August 2020

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PubMed Search: Gross[TI] liver[TI]


Deepali Jain, M.D.
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Cite this page: Jain D. Grossing, frozen section & features to report. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/livertumorgrossing.html. Accessed September 25th, 2020.
Grossing
  • At least one section per 2 cm of tumor for large tumors, including tumor center and periphery
  • Submit entire tumor, if can do so in 5 sections or less
  • Adjacent and distant uninvolved liver
  • Resection margins
  • Portal and hepatic veins
  • Porta hepatis
  • Lymph nodes
  • Gallbladder, if present
  • Other tissues or organs
  • Save intervening levels on biopsies for special stains
Frozen section
  • Accurate and reliable for intraoperative diagnosis of suspected liver lesions (J Clin Pathol 2006;59:352) - biliary hamartoma is most common entity confused with a malignant tumor
  • Pretransplant frozen section also used to evaluate donor livers for macrovesicular steatosis, although discrepancies exist with permanent sections in 7% (J Clin Med Res 2011;3:191)
  • Optimally, should have clinical data and serum AFP levels available
  • Should know if specimen is from a mass
Features to report - gross
Features to report - microscopic description
  • Tumor histologic type, tumor grade (specify grading system) and pattern
  • Number and size (3 dimensions) of tumor nodules
  • Status of resection margins (ask surgeon which margins are important to evaluate)
  • Severity of fibrosis (none, mild, moderate, severe, cirrhosis)
  • Angiolymphatic invasion
  • Mitotic rate
  • Findings in nonmalignant liver, including cirrhosis, iron deposition, other tumors, portal vein thrombosis, hepatocyte dysplasia and hepatitis
  • Regional lymph nodes: number examined, number and location with metastatic tumor
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