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Questions and Answers
What is the primary reason an appendix is generally removed?
What is the primary reason an appendix is generally removed?
- Acute appendicitis (correct)
- Chronic gastrointestinal issues
- Routine examination during laparoscopic surgery
- Preventative measure for colorectal cancer
In a cone biopsy procedure, what shape is the tissue that is removed from the cervix?
In a cone biopsy procedure, what shape is the tissue that is removed from the cervix?
- Circular
- Cone-shaped (correct)
- Rectangular
- Cube-shaped
Which of the following correctly describes the dimensions of a specimen described in a sample dictation for an appendix?
Which of the following correctly describes the dimensions of a specimen described in a sample dictation for an appendix?
- 6 cm in length × 1 cm in diameter
- 5 cm in length × 0.9 cm in diameter (correct)
- 5 cm in length × 2 cm in diameter
- 7 cm in length × 1.5 cm in diameter
What is one of the specifications that should be noted when processing an appendix?
What is one of the specifications that should be noted when processing an appendix?
What unusual finding might be recorded during the processing of the appendix's mucosal surface?
What unusual finding might be recorded during the processing of the appendix's mucosal surface?
What does the term 'salpingo-oophorectomy' refer to?
What does the term 'salpingo-oophorectomy' refer to?
Which procedure is most likely to involve the collection of multiple specimens from the cervix?
Which procedure is most likely to involve the collection of multiple specimens from the cervix?
When cutting sections of the appendix for processing, at what intervals should the remainder of the appendix be sectioned?
When cutting sections of the appendix for processing, at what intervals should the remainder of the appendix be sectioned?
What should be recorded regarding the appendix when examining its condition?
What should be recorded regarding the appendix when examining its condition?
Which type of sample submission is required if mucin accumulation is present in the lumen?
Which type of sample submission is required if mucin accumulation is present in the lumen?
In what scenario would a total hysterectomy specimen be processed differently?
In what scenario would a total hysterectomy specimen be processed differently?
What specific sections are required when submitting the appendix after an appendectomy for a normal gross appearance?
What specific sections are required when submitting the appendix after an appendectomy for a normal gross appearance?
What does 'RSS' denote in the context of submitting appendix specimens?
What does 'RSS' denote in the context of submitting appendix specimens?
What additional structures are involved in a radical hysterectomy for malignancy?
What additional structures are involved in a radical hysterectomy for malignancy?
What should be done with specimens from total hysterectomies for benign conditions?
What should be done with specimens from total hysterectomies for benign conditions?
Which type of abnormality should be noted in the appendix lumen contents during examination?
Which type of abnormality should be noted in the appendix lumen contents during examination?
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Study Notes
Grossing Simple Specimens
- LEEP (Loop Electrosurgical Excision Procedure): Technique using a wire to remove abnormal cells from the cervix.
- Commonly results in multiple specimens, including anterior and posterior cervix.
- Cone Biopsy of the Cervix: Surgical removal of a cone-shaped tissue section from the cervix, encompassing both upper and lower parts.
- Resection: Surgical removal of all or part of an organ or body structure.
- Segmental Resection (Segmentectomy): Partial removal of an organ or other body structure.
- Salpingo-Oophorectomy: Removal of the fallopian tube (salpingectomy) and ovary (oophorectomy).
Appendix Processing
- Reasons for Appendectomy: Acute appendicitis, incidental removal during other surgeries, or as part of a right colectomy.
- Appendix Appearance:
- Dimensions: Length, diameter, and range of dimensions.
- Color: Tan/pink, gray/green.
- External Surface: Edema, fibrinous exudate, hyperemia (redness), purulence, perforations, hemorrhage (possible indication of endometriosis).
- Mesoappendix: Dimensions, color (e.g., tan/brown), edematous, fibrinous exudate, purulence, hemorrhagic areas.
- Sections and Submission:
- Longitudinal Section: Of the tip, extending into a cassette, serosa may be inked for orientation.
- Transverse Sections: At 3mm intervals.
- Record: Wall thickness, lumen diameter (dilated, fibrosed, constricted), mucosa condition (glistening, ulcerated, hyperemic), lumen contents (fecalith, foreign body, purulence, blood, parasites, mucin, fibrous obliteration).
- Submit: One longitudinal section of the tip and two transverse sections (one near the resection margin and one near the tip), including any abnormalities.
- If Mucin Accumulation or Suspicious Tumor: Submit the entire appendix and the resection margin separately.
- Grossly Normal Appendix with Appendectomy for Appendicitis: Submit the entire specimen.
Cassettes for Appendix
- Cassette 1: Longitudinal section of the tip and proximal margin, 2 fragments, representative section submitted (RSS).
- Cassette 2: Cross-sections including the area of perforation, 4 fragments, representative section submitted (RSS).
Complex Specimen Grossing: Hysterectomy and Salpingo-Oophorectomy
- Specimen Categories:
- Total hysterectomy for benign conditions (e.g., prolapse or fibroids).
- Total hysterectomy for malignant conditions (e.g., endometrial carcinoma).
- Radical hysterectomy for malignant conditions (e.g., cervical carcinoma) including vaginal cuff, parametrium, and regional lymph nodes.
- Processing: The entire specimen is submitted. One level is examined for women.
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