Larynx, hypopharynx & trachea
General
Grossing & features to report
Author: Nat Pernick, M.D.
Last author update: 1 December 2013
Last staff update: 7 March 2023
Copyright: 2002-2023, PathologyOutlines.com, Inc.
PubMed Search: Grossing
Cite this page: Pernick N. Grossing & features to report. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/larynxgrossing.html. Accessed September 26th, 2023.
Grossing
- Open in midline posteriorly, ink margins, take tissue for special studies
- Fix specimen
- Remove hyoid bone and inspect pre-epiglottic tissue
- Slice larynx (see below) and photograph
- For supraglottic and hypopharyngeal carcinomas, blocks should include relationship between tumor and anterior resection margin at base of tongue
- For partial laryngectomy specimens, inferior margin is usually most critical
- At least one section per 1 cm of tumor for large tumors, including tumor center and periphery and maximum depth of invasion
- Submit entire tumor if can do so in 5 sections or less
- Submit resection margins
- Nonneoplastic mucosa
- Bone or cartilage that is grossly involved by tumor
- Thyroid gland if present
- Lymph nodes
- Tracheostomy site
- Glottic tumors: show tumor relationship to ventricle, thyroid cartilage and cricoid cartilage by coronal section (plane dividing body into front and back, coronal section of normal larynx)
- Epiglottic tumors: determine extent of invasion of preepiglottic space by sagittal sections (plane dividing body into right and left, sagittal section of larynx)
- Pyriform sinus tumors: show invasion of supraglottic larynx and thyroid lamina by horizontal sections
Features to report
- Editor's note
- Tumor size and location
- Tumor histologic type and pattern
- Tumor histologic grade
- Depth of invasion of primary tumor
- Pattern of invasion
- Tumor extension to adjacent structures (indicate involvement or not)
- Status of resection margins (distance from invasive carcinoma to mucosal and deep margins)
- Vascular invasion
- Perineural invasion
- Presence of severe dysplasia / carcinoma in situ
- Lymph nodes: for each level, number obtained, number involved by tumor, size of nodal metastases and presence of extracapsular spread
- TNM staging
Additional references
