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Difference between revisions of "Cystoprostatectomy grossing"
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==Introduction== | ==Introduction== | ||
Cystoprostatectomies are done for [[bladder cancer]]. Granular areas of the [[urinary bladder|bladder]] often correlate with [[urothelial carcinoma in situ|carcinoma in situ]]. | Cystoprostatectomies are done for [[bladder cancer]]. Granular areas of the [[urinary bladder|bladder]] often correlate with [[urothelial carcinoma in situ|carcinoma in situ]]. | ||
Lack of a tumour is common in muscle invasive cases that had neoadjuvant therapy; approximately 15% of cases are ypT0.<ref name=pmid22915241>{{Cite journal | last1 = D'Souza | first1 = AM. | last2 = Pohar | first2 = KS. | last3 = Arif | first3 = T. | last4 = Geyer | first4 = S. | last5 = Zynger | first5 = DL. | title = Retrospective analysis of survival in muscle-invasive bladder cancer: impact of pT classification, node status, lymphovascular invasion, and neoadjuvant chemotherapy. | journal = Virchows Arch | volume = 461 | issue = 4 | pages = 467-74 | month = Oct | year = 2012 | doi = 10.1007/s00428-012-1249-4 | PMID = 22915241 }}</ref> | |||
==Specimen opening== | ==Specimen opening== | ||
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**Continue cut through urethra upward to left and upward to right - such that anterior bladder wall can be flipped upward. | **Continue cut through urethra upward to left and upward to right - such that anterior bladder wall can be flipped upward. | ||
**Should be pinned open on a large block of paraffin wax. | **Should be pinned open on a large block of paraffin wax. | ||
***A paper towel should be placed behind the specimen - between the specimen and paraffinx wax. | |||
*Place specimen(s) in [[formalin]]. | |||
==Protocol== | ==Protocol== | ||
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*§ This is how it is done in [[prostatectomy|prostatectomies]]. | *§ This is how it is done in [[prostatectomy|prostatectomies]]. | ||
*† The parasagittal sections of the bladder and prostate are important for staging. | *† The parasagittal sections of the bladder and prostate are important for staging. | ||
**Invasion into the prostatic stroma is pT4. | |||
**The parasagittal sections should contain the interface between the bladder and prostate. It is ''not'' recommended that those sections extend further into the prostate or through the prostate. | |||
*‡ Should be in separate blocks ''or'' inked with different colours (such that they can be separated at time of microscopy). | *‡ Should be in separate blocks ''or'' inked with different colours (such that they can be separated at time of microscopy). | ||