Home   Chapter Home   Jobs   Conferences   Fellowships   Books



Miscellaneous tumors

Grossing hysterectomy specimens

Reviewer: Nat Pernick, M.D. (see Reviewers page)
Revised: 4 September 2011, last major update September 2011
Copyright: (c) 2002-2011, PathologyOutlines.com, Inc.

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

IARC: various images for grossing protocol

Morcellated specimen: endometrium identified as a slit like space

End of Uterus > Miscellaneous tumors > Grossing hysterectomy specimens

This information is intended for physicians and related personnel, who understand that medical information is often imperfect, and must be interpreted in the context of a patient's clinical data using reasonable medical judgment. This website should not be used as a substitute for the advice of a licensed physician.

All information on this website is protected by copyright of PathologyOutlines.com, Inc. Information from third parties may also be protected by copyright. Please contact us at [email protected] with any questions (click here for other contact information).