Pleura & peritoneum

Topic Completed: 1 January 2014

Minor changes: 2 September 2020

Copyright: 2003-2021,, Inc.

PubMed Search: Pleural gross mesothelial

Vaidehi Avadhani, M.D.
Page views in 2020: 239
Page views in 2021 to date: 4
Cite this page: Avadhani V. Grossing. website. Accessed January 16th, 2021.
Types of specimen
  • Biopsy
  • Pleurectomy
Surgical procedures definition
  • Pleurectomy / decortication with mediastinal lymph node sampling:
    • Complete removal of pleura and all gross tumor
  • Extrapleural pneumonectomy:
    • En bloc resection of pleura, lung, ipsilateral diaphragm; may include pericardium
Grossing - biopsy
  • If received for frozen section, ensure enough lesional tissue is present
  • Ask for additional tissue if tissue submitted needs to be entirely frozen
    • Important because immunohistochemistry may be unreliable on previously frozen tissue
    • May need to send for special studies including electron microscopy and cytogenetics
Grossing pleurectomy
    1. Describe dimension and number of fragments, any lesions present
    2. Note if pleural plaques are seen; describe
    3. Tumor involvement of adjacent structures - lung, diaphragm, pericardium, skeletal muscle
    4. Ink margins in sections closest to tumor
    5. Tumor:
      • One section per cm of tumor
      • Extensive sampling if desmoplastic mesothelioma is suspected
    6. Additional sections of lung, if present (for asbestos fiber analysis):
      • Recommended - up to 5
    7. Sections for ancillary tests:
      • Electron microscopy, cytogenetics, etc., if necessary
    8. Lymph nodes
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