[Pathoanatomical preparation and reporting for dysplasias and cancers of the cervix uteri: cervical biopsy, conization, radical hysterectomy and exenteration].
A careful macroscopic description with selection of representative tissue for histological examination is required for quality assurance, for assessing prognostic factors and for answering legal questions in (pre)cancerous lesions of the cervix uteri. Exact and standardized gross inspection and preparation are decisive for the quality of the histopathological statement. The extent of cervical carcinomas should be given in three dimensions, including the relative depth of invasion into the cervical wall. The report should include size, type (according to the WHO classification) and grading of the tumor, the presence of lymphatic as well as blood vessel invasion and perineural involvement. The statement for resection margins should include the vaginal, parametrial, rectal and vesical directions. It is also mandatory to document the number of lymph nodes with metastatic disease in relation to the total number of nodes investigated. The staging should follow the TNM system. In the handling of conisation specimens, it is important to appropriately document localization, horizontal expansion, depth of invasion including microinvasion of any dysplastic or malignant lesions. Clockwise dissection of the conisation specimen, total submission, and step sections are recommended. The preparation of exenteration specimens is a highly skilled job: the exact tumor dimension should be given in its relation to all resected organs and structures with special focus on resection margins.
Horn
L-C
LC
Abt. für Gynäko- & Perinatalpathologie, Institut für Pathologie, Universität, Liebigstrasse 26, 04103, Leipzig. hornl@medizin.uni-leipzig.de
Einenkel
J
J
Höckel
M
M
Kölbl
H
H
Kommoss
F
F
Lax
S F
SF
Reich
O
O
Riethdorf
L
L
Schmidt
D
D
D001706:Biopsy; D004717:Endometrium / Q000473:pathology; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology; D009367:Neoplasm Staging; D002583:Uterine Cervical Neoplasms / Q000473:pathology* / Q000601:surgery*