Which Way is Up? Policies and Procedures for Surgeons and Pathologists Regarding Resection Specimens of Thymic Malignancy Frank C. Detterbeck, MD, Cesar.

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Presentation transcript:

Which Way is Up? Policies and Procedures for Surgeons and Pathologists Regarding Resection Specimens of Thymic Malignancy Frank C. Detterbeck, MD, Cesar Moran, MD, James Huang, MD, Saul Suster, MD, Garrett Walsh, MD, Lawrence Kaiser, MD, Mark Wick, MD Journal of Thoracic Oncology Volume 6, Issue 7, Pages S1730-S1738 (July 2011) DOI: 10.1097/JTO.0b013e31821ea567 Copyright © 2011 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 1 Mediastinal board. A diagram on a soft board is useful in maintaining proper dimensions and orientation of specimens. Printing this figure as a full page corresponds roughly to the normal mediastinal dimensions and can be placed directly on a standard soft specimen board that is generally available in surgical pathology departments. Journal of Thoracic Oncology 2011 6, S1730-S1738DOI: (10.1097/JTO.0b013e31821ea567) Copyright © 2011 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 2 Resected specimen oriented on the mediastinal board. Placement of the specimen and the paper diagram or board provides unambiguous orientation, depicts the relationship to other mediastinal structures, and maintains the normal size of the resected tissue. Pins placed through the tissue into the board or paper diagram can be used to hold it in place if needed. Journal of Thoracic Oncology 2011 6, S1730-S1738DOI: (10.1097/JTO.0b013e31821ea567) Copyright © 2011 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 3 Sketch of the oriented specimen on a mediastinal diagram. The sketch depicts marking stitches and additional resected structures diagrammatically, which minimizes subsequent confusion and aids communication. Journal of Thoracic Oncology 2011 6, S1730-S1738DOI: (10.1097/JTO.0b013e31821ea567) Copyright © 2011 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 4 A, Inked specimen, anterior aspect. Blue ink labels the anterior aspect and yellow ink the right lateral aspect of the tumor (on the left side of the photograph). B, Inked specimen, posterior aspect. The posterior aspect of the specimen has been inked with black ink. Note the yellow ink labeling the right lateral aspect of the tumor on the right side of the figure. Journal of Thoracic Oncology 2011 6, S1730-S1738DOI: (10.1097/JTO.0b013e31821ea567) Copyright © 2011 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 5 Bread-loafed tumor specimen. The tumor mass has been sectioned from superior to inferior in a bread-loaf manner into thin sections. This is useful to document specific gross features and to identify specific areas that may require special attention and histopathological assessment. Note that the different colors are easily identifiable. Journal of Thoracic Oncology 2011 6, S1730-S1738DOI: (10.1097/JTO.0b013e31821ea567) Copyright © 2011 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 6 Remaining uninvolved thymic tissue. Random sections of this tissue should be obtained for histopathological assessment. Journal of Thoracic Oncology 2011 6, S1730-S1738DOI: (10.1097/JTO.0b013e31821ea567) Copyright © 2011 International Association for the Study of Lung Cancer Terms and Conditions