Total nephrectomy for tumour grossing

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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: [partial 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.

Protocol notes

Alternate approaches

See also

Related protocols

References

External links