CCIV Male Repro Prosections

1. check req and hx

2. measure length x diameter

3. SSCCPT overall - lesions and uninvolved

4. ink resection margin

5. < 3mm submit as is, > 4mm bisect or trisect

penile bx

1. check req and hx

2. measure in 2D and depth

3. SSCCPT skin surface

4. ink margin (if older for inflammation or tumor)

5. serially section

6. SSCCPT cut surface - lesion and uninvolved

7. rep sections

   1. typically gross only for newborns

foreskin

1. check req and hx

2. measure overall in LxD, foreskin in 3D

3. SSCCPT overall

   1. lesion - growth pattern, consistency, borders

   2. measure lesion to closest margin

4. ink ST and skin resection margins

5. open urethra along ventral aspect, then bisect specimen

6. SSCCPT tumor:

   1. 2D + DOI

   2. relationship to foreskin, frenulum, glans, meatus, corpora, urethra

7. SSCCPT uninvolved

8. Sections:

   1. 1/cm GD of tumor:

      1. tumor to ST margin, en face

      2. tumor to skin margin, en face

      3. tumor at greatest DOI

      4. tumor to corpora cavernosa

      5. tumor to corpus spongiosum

      6. tumor to urethra

      7. tumor to foreskin

   2. uninvolved:

      1. corpora cavernosa

      2. corpus spongiosum,

      3. forskin

penis for SCC

1. check req and hx - NOT for tumor, only fertility assessment

2. measure in 3D

3. SSCCPT overall

4. submit entirely

5. special stains: trichrome, elastic stain, PAS

testicular bx

1. check req and hx

2. measure in LxD

3. SSCCPT outer surface

4. submit entirely, intact

   1. sectioned in histology to ensure proper embedding

vas deferens for sterilization

1. check req and hx

2. weigh

3. measure:

   1. testicle in 3D

   2. epididymis in 3D

   3. spermatic cord LxD

4. bivalve

5. SSCCPT cut surface

6. rep sections:

   1. shave of spermatic cord margin

   2. rep section of epididymis

   3. rep section of testicular parenchyma

benign orchiectomy - torsion, removal of hormone influence for prostate cancer or gender confirming surgery

1. check req and hx

2. weigh

3. measure:

   1. testicle in 3D

   2. epididymis in 3D

   3. spermatic cord LxD

4. ink enitre outer surface 1 color

5. shave spermatic cord margin

   1. vas deferens can retract!

6. serially section spermatic cord

7. bivalve parallel to and towards the epididymis

8. SSCCPT lesion:

   1. measure in 3D

   2. distance to tunica albuginea and vaginalis

      1. “tunica vaginalis falls away and is not involved by the tumor”

   3. distance to spermatic cord margin

   4. distant to rete testis/hilum

   5. note variegation, hemorrhage, necrosis

9. SSCCCPT uninvolved:

   1. tubules do/do not “string with ease”

10. Sections:

    1. spermatic cord margin, en face

    2. 1/cm GD of tumor:

       1. tumor to tunica albuginea

       2. tumor to tunica vaginalis (or rep)

       3. tumor to epididymis

       4. tumor rete testis

       5. tumor to uninvolved adjacent

       6. heterogeneous areas (pathologist needs to determine % of each for mixed)

    3. uninvolved:

       1. testicular parenchyma

       2. epididymis

       3. spermatic cord: mid and peritesticular

orchiectomy for tumor

1. check req and hx

2. number of cores

3. measure in LxD

4. SSCCPT overall

5. submit entirely in lens paper or sponges

   1. no more than 2-3 cores per cassette

prostate: needle core biopsy

1. check the req and hx

2. weigh

3. measure in 3D agg and range

4. SSCCPT overall

   1. yellow-orange = suspicious!

   2. calcs may be present

5. sections:

   1. < 12 g = submit entirely

   2. > 12 g = submit first 12 g entirely (6-8 cassettes) + 1 additional cassette per 5 g

   3. ex: 22g = 8-10 cassettes

TURP

1. check req and hx; make sure prostate is not in a bag before fixing; radioactive seeds may be present!!

2. weigh

3. orient - seminal vesicles/vas deferens on posterior aspect of base (superior)

4. measure:

   1. prostate gland in 3D with orientation

   2. R/L seminal vesicles in 3D

   3. R/L vas deferens in LxD

5. SSCCPT capsule

6. probe urethra and differentially ink R/L halves with posterior overlay

7. shave R/L vas deferens margins

8. amputate R/L seminal vesicles and submit section with junction of prostate base

9. shave apex and base urethral margins - serially or radially section and submit entirely

10. serially section remainder of prostate gland from apex to base at 0.5 cm

    1. lay out sections keeping consistent orientation and number them

11. SSCCPT lesion: may be difficult to grossly define - use biopsy site and palpate

    1. measure in 3D

    2. describe location of tumor (A, P, L, R, and slice number)

    3. distance to capsule

    4. distance to vas deferens and seminal vesicle margins

12. SSCCPT remainder of cut surface

13. sections:

    1. R vas deferens margin and R seminal vesicle + prostatic base

    2. L vas deferens margin and L seminal vesicle + prostatic base

    3. proximal and distal urethral margins, entirely submitted, on edge

    4. submit odds slices entirely, submit posterior quadrants of even slices

radical prostatectomy for adenocarcinoma

• bladder:

  • R/L ureter margins

  • 1/cm GD of tumor

    • relationships, greatest DOI and to deep adventitia or serosa

  • 2 reps from each wall

• prostate:

  • R/L vas deferens margins

  • R/L seminal vesicles with adjacent bone

  • distal urethral margin, entirely submitted, on edge

  • lesion relationships

  • reps uninvolved

  • posterior entirely, anterior every other?

cystoprostatectomy sections