Total nephrectomy for tumour grossing

This article deals with the cut-up of nephrectomy specimens.

Introduction

Nephrectomies are typically done for kidney tumours.

They come in three basics flavours:

• Partial nephrectomy.
• Nephrectomy.
• Radical nephrectomy - includes Gerota's fascia.
  • Gerota's fascia is the fascia overlying the perinephric fat).

Protocol

Dimensions:

• Type: [total nephrectomy/radical nephrectomy].
• Laterality: [left / right].
• Weight: ___ grams.
• Size of specimen (superior-inferior, left-right, anterior-posterior): ___ x ___ x ___ cm.
• Size of kidney (superior-inferior, left-right, anterior-posterior): ___ x ___ x ___ cm.
• Perinephric fat (maximal dimension): ___ cm.
• Adrenal gland: [___ x ___ x ___ cm / no identified].
• Ureter (length x diameter): ___ x ___ cm.
• Renal vein (length x diameter): ___ x ___ cm.
• Renal artery (length x diameter): ___ x ___ cm.

Tumour:

• Dimensions (superior-inferior, left-right, anterior-posterior): ___ x ___ x ___ cm.
• Location: [upper pole / mid / lower pole].
• Colour: [yellow, tan, white].
• Circumscription: [well circumscribed, infiltrative border].
• Friability: [friable/not friable].
• Hemorrhage: [present/absent].
• Necrosis: [present/absent].
• Nearest margin: ___ cm.
• Extension into perinephric fat: [absent/absent-pushing border/suspicious/present].
• Extension into renal hilar fat: [absent/absent-pushing border/suspicious/present].
• Extension into the collecting system: [absent/suspicious/present].
• Extension into renal vein: [absent/suspicious/present].

Other:

• Non-tumour parenchyma: [cortex unremarkable / thinned].
• Collecting system mucosa: [smooth and regular / granular / irregular / dilated].

Representative sections are submitted:

• Renal vein margin.
• Ureter margin and renal artery margin.
• Tumour with nearest margin.
• Tumour and perinephric fat.
• Tumour and hilar fat.
• Normal kidney.
• Adrenal gland.