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Difference between revisions of "Total nephrectomy for tumour grossing"
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Total nephrectomy for tumour grossing (view source)
Revision as of 17:19, 29 August 2014
, 17:19, 29 August 2014no edit summary
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Representative sections are submitted: | Representative sections are submitted: | ||
*Renal vein margin. | *Renal vein margin. ‡ | ||
*Ureter margin and renal artery margin. | *Ureter margin and renal artery margin. | ||
*Tumour with nearest margin. | *Tumour with nearest margin. | ||
*Tumour and perinephric fat. | *Tumour and perinephric fat. † | ||
*Tumour and hilar fat. | *Tumour and hilar fat. † | ||
*Normal kidney. | *Normal kidney. | ||
*Adrenal gland. | *Adrenal gland. | ||
| Line 61: | Line 59: | ||
===Protocol notes=== | ===Protocol notes=== | ||
*Tumour [[stage]] size cut points: <=4 cm, <=7 cm. | *Tumour [[stage]] size cut points: <=4 cm, <=7 cm. | ||
*It is important to sample the renal vein wall if tumour thrombus projecting out of the renal vein, as a positive margin is called based on microscopic involvement of the vein wall.<ref name=pmid24025521>{{Cite journal | last1 = Trpkov | first1 = K. | last2 = Grignon | first2 = DJ. | last3 = Bonsib | first3 = SM. | last4 = Amin | first4 = MB. | last5 = Billis | first5 = A. | last6 = Lopez-Beltran | first6 = A. | last7 = Samaratunga | first7 = H. | last8 = Tamboli | first8 = P. | last9 = Delahunt | first9 = B. | title = Handling and staging of renal cell carcinoma: the International Society of Urological Pathology Consensus (ISUP) conference recommendations. | journal = Am J Surg Pathol | volume = 37 | issue = 10 | pages = 1505-17 | month = Oct | year = 2013 | doi = 10.1097/PAS.0b013e31829a85d0 | PMID = 24025521 }}</ref> | *‡ It is important to sample the renal vein wall if tumour thrombus projecting out of the renal vein, as a positive margin is called based on microscopic involvement of the vein wall.<ref name=pmid24025521>{{Cite journal | last1 = Trpkov | first1 = K. | last2 = Grignon | first2 = DJ. | last3 = Bonsib | first3 = SM. | last4 = Amin | first4 = MB. | last5 = Billis | first5 = A. | last6 = Lopez-Beltran | first6 = A. | last7 = Samaratunga | first7 = H. | last8 = Tamboli | first8 = P. | last9 = Delahunt | first9 = B. | title = Handling and staging of renal cell carcinoma: the International Society of Urological Pathology Consensus (ISUP) conference recommendations. | journal = Am J Surg Pathol | volume = 37 | issue = 10 | pages = 1505-17 | month = Oct | year = 2013 | doi = 10.1097/PAS.0b013e31829a85d0 | PMID = 24025521 }}</ref> | ||
**Tumour projecting out of the vein (i.e. at surface of specimen), at the time of grossing, is presumed to be due to retraction of the vein after it is cut. | **Tumour projecting out of the vein (i.e. at the surface of specimen), at the time of grossing, is presumed to be due to retraction of the vein after it is cut. | ||
*† If fat invasion obvious = 1 section. | |||
**Suspicion of fat invasion = 3 sections. | |||
===Alternate approaches=== | ===Alternate approaches=== | ||