Grossing hysterectomy specimens

Topic Completed: 1 September 2011

Minor changes: 7 October 2019

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PubMed search: histologic sampling hysterectomy

Nat Pernick, M.D.
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Cite this page: Pernick N. Grossing hysterectomy specimens. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/uterusgrossing.html. Accessed May 26th, 2020.
Procedure (tumor)
  • Measure, weigh, describe, photograph
  • Open along lateral sides
  • Ink serosa adjacent to tumor, vaginal margin of resection
  • Section from endocervical canal to superior aspect
  • If cervical tumor present / suspected, amputate cervix and process as cone biopsy
Sections to obtain
No significant gross pathology:
  • Anterior and posterior cervix (important for identifying carcinoma in situ, J Clin Pathol 2002;55:629)
  • Anterior and posterior endomyometrium
  • Lower uterine segment
  • Each ovary (cortex, hilar region) and fallopian tube
  • Any gross lesions, including leiomyomas

Suspected tumor:
  • Above, plus:
  • With tumor, full thickness endomyometrium and serosa to assess depth of invasion
  • 1 section per 1 cm of tumor, minimum 3 sections
  • All grossly different appearing regions of tumor
  • High endocervical canal or lower isthmus
  • Ink and obtain margins of resection, including vaginal mucosa

  • Notes: in laparoscopic hysterectomies, pathologists may create artifactual vascular invasion by mechanically transporting tumor into vascular spaces during the grossing process (Am J Surg Pathol 2009;33:298)
  • May be difficult to identify specific cervical anatomic regions in morcellated specimens (Indian J Pathol Microbiol 2010;53:634)
Gross images / diagrams

Images hosted on other servers:

IARC: various images for grossing protocol

Morcellated specimen:
identified as a
slit-like space

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