Difference between revisions of "Hysterectomy"
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*Any smooth muscle tumor. {{further|Smooth muscle tumor|linebreak=no}} | *Any smooth muscle tumor. {{further|Smooth muscle tumor|linebreak=no}} | ||
− | ====Slices for microscopy=== | + | ====Slices for microscopy==== |
Submit:<ref name=stora/> | Submit:<ref name=stora/> | ||
*Four cross-sectiosn from any accompanying ectocervix. In subtotal extirpation, a cross-section is taken from the lower resection border. | *Four cross-sectiosn from any accompanying ectocervix. In subtotal extirpation, a cross-section is taken from the lower resection border. |
Revision as of 05:10, 29 January 2020
Author:
Mikael Häggström [note 1]
Contents
Gross processing
Benign conditions
Applicable in bleeding disorders, pain, leiomyoma and endometrial hyperplasia.[1]
Gross examination
For orientation:
- The round ligament lies anterior to the tubes and ovaries.[1]
- The peritoneum extends further down along the cervix posteriorly than anteriorly.[2] Its ends bluntly posteriorly and sharply anteriorly.[2]
Optionally, remove the adnexa.[1]
Steps:[1]
- Perform a general inspection
- Measure length, width, thickness
- The uterus is usually opened at the front in the midline, optionally with an incision towards each corner.[notes 1] Open the cavity completely, along the existing incision. The cavity is sometimes be squeezed or rolled around a leiomyoma, and you'll you have to improvise and perhaps go around the leiomyoma to open the cavity properly. Cut through the front wall into both corners.
- Inspect the mucosa. If any polyps, see Endometrial polyp
- Measure the thickness of the mucosa and myometrium
- Inspect the myometrium. If any tumor, see Smooth muscle tumor
Gross report
Components:[1]
- Shape of uterus and adnex
- Measurements
- Mucosa, such as smooth or irregular.
- Any polyps. Further information: Endometrial polyp
- Mucosal and endometrial thickness
- Any smooth muscle tumor. Further information: Smooth muscle tumor
Slices for microscopy
Submit:[1]
- Four cross-sectiosn from any accompanying ectocervix. In subtotal extirpation, a cross-section is taken from the lower resection border.
- A transverse slice through the endocervix, possibly divided into two.
- One slice from the front and one from the back wall of the corpus, and one piece from each corner, including myometrium.
- Any mucosal parts with macroscopically abnormal appearance, including polyps.
- In case of endometrial hyperplasia, most of the mucosa of the corpus and fundus.
- Samples form all smooth muscle tumors >5 cm in diameter. Further information: Smooth muscle tumor
Notes
- ↑ The uterus can also be opened laterally, through the parameters.
- ↑ 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.
Main page
References
- ↑ 1.0 1.1 1.2 1.3 1.4 1.5 Monica Dahlgren, Janne Malina, Anna Måsbäck, Otto Ljungberg. Stora utskärningen. KVAST (Swedish Society of Pathology). Retrieved on 2019-09-26.
- ↑ 2.0 2.1 . General Specimen Orientation Tips. The University of Michigan (2020-01-29).
Image sources