Larynx, hypopharynx & trachea


Grossing & features to report

Last author update: 1 December 2013
Last staff update: 7 March 2023

Copyright: 2002-2023,, Inc.

PubMed Search: Grossing

Nat Pernick, M.D.
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Cite this page: Pernick N. Grossing & features to report. website. Accessed September 26th, 2023.
  • 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
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