Generally 10% neutral buffered formalin.
- See also: General notes on fixation
- Measure length, as well as the transverse and sagittal diameter of the ectocervical surface.
- Optionally, weight the sample.
- Note the symmetry of the sample, and the position of the cervical canal.
- Note whether the circumference is complete. If not, and the directions are indicated on the cone, determine the approximate position of the defect.
- Cones excised by knife should be inked on the excision surfaces.[notes 2] Those excised by laser do not need inking.
Selection and trimming
- If the cone is more than 1 cm long, take transverse slices from the top of the cone and towards the ectocervix, and stop when approximately 1 cm of the ectocervical portion of the cone remains.
- Cut the portion into radial or sagittal slices. Sagittal slices are made perpendicularly to the portion surface, and should be divided into at least the four quadrants.[notes 3]
In cases where the cone is small and fragmented, try to orient the preparations and divide them if possible to obtain sagittal slices.
- See also: General notes on gross processing
Look for dysplasia in the transformation zone.
|Histology Grade||Corresponding Cytology||Description||Image|
|CIN 1 (Grade I)||Low-grade squamous intraepithelial lesion (LSIL)||
|CIN 2/3||High-grade squamous intraepithelial lesion (HSIL)[notes 4]||
|CIN 2 (Grade II)[notes 5]||
|CIN 3 (Grade III)[notes 6]||
Look whether there is normal epithelium on each side of all slices where neoplasia is seen, and when the epithelium is missing in any direction, consider ordering additional serial sections or step sections.
If a neoplasia is found, the report should include:
- The histolopathological type and degree of differentiation
- Location and extent
- See also: General notes on reporting
- For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Patholines:Authorship for details.
- Inking can be done with India ink, and will specify the serosa or resection margin in later histopathologic evaluation.
- Each slice may be individually numbered.
- HSIL+ encompasses HSIL, AGC, and cancer
- CIN 2+ encompasses CIN 2, CIN 3, adenocarcinoma in situ (AIS), and cancer
- CIN 3+ encompasses CIN 3, AIS, and cancer
- Monica Dahlgren, Janne Malina, Anna Måsbäck, Otto Ljungberg. Stora utskärningen. KVAST (Swedish Society of Pathology). Retrieved on 2019-09-26.
- Nagi, Chandandeep S.; Schlosshauer, Peter W. (2006). "Endocervical glandular involvement is associated with high-grade SIL ". Gynecologic Oncology 102 (2): 240–243. doi:10.1016/j.ygyno.2005.12.029. ISSN 00908258.