CCIV Hepatobiliary Prosections

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4 Terms

1
New cards

  1. check req and hx

  2. weigh

  3. measure in 3D

  4. SSCCPT overall

  5. ink resection margin - remove small staples clamping vessels

  6. serially section perpendicular to the resection margin

  7. SSCCPT mass:

    1. measure in 3D

    2. measure to resection margin

    3. measure to capsule

    4. distance to other important structures if present (vessels)

  8. SSCCPT uninvolved

  9. Sections:

    1. 1/cm GD of tumor

      1. tumor to resection margin

      2. tumor to adjacent uninvolved

      3. tumor to other structures

    2. uninvolved liver

wedge/segmentectomy

2
New cards

  1. check req and hx

  2. measure in length and diameter, give #

  3. SSCCPT overall

  4. submit entirely in biopsy bag or sponges in 2 cassettes if possible

  5. 88307 - lots of stains ordered

liver core bx

3
New cards

  1. check req and hx

  2. orient and ID structures present

  3. weigh (± gallbladder)

  4. measure in 3D with directionality

    1. measure gallbladder in 3D if present

  5. SSCCPT overall

  6. shave hilar margins:

    1. hepatic veins (3)

    2. porta hepatis: CBD, hepatic artery, and portal vein margin

  7. palpate for LN

  8. serially section perpendicular to the long axis from the anterior side

  9. SSCCPT cut surface

    1. if mass: 3D, distance to hilar margins, capsule, gallbladder; % necrosis if TACE

    2. if diffuse give %

  10. SSCCPT uninvolved

  11. gallbladder: open, SSCCPT contents, mucosa, wall thickness

  12. sections:

    1. hepatic artery margin, en face

    2. portal vein margin, en face

    3. CBD margin, en face

    4. hepatic vein margins, en face

    5. 1/cm GD of tumor:

      1. tumor to capsule

      2. tumor to uninvolved

      3. tumor to vessels

      4. additional heterogenous tumor or TACE

    6. rep section each segment or 2 per lobe

    7. gallbladder wall, cystic duct + LN

    8. LN

total hepatectomy

4
New cards

  1. check req and hx

  2. orient: cystic duct margin, serosa and adventitia

  3. measure in 3D

  4. SSCCPT overall

  5. ink and shave cystic duct margin

  6. open with scissors from fundus towards cystic duct along serosal surface

  7. examine cystic duct for obstruction

  8. SSCCPT: wall thickness, mucosa, contents (bile, stones)

    1. measure stones in range of GD and 3D agg

  9. sections:

    1. cystic duct margin, en face

    2. uninvolved fundus, body, neck

    3. cystic duct LN

gallbladder