Intestine with tumor

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Author: Mikael Häggström [note 1]

Gross examination

  • Determine the proximal (oral) and distal (aboral) parts of the specimen if possible.[1]
  • Measure the length and diameter of the entire specimen.[1]
  • Surfaces that appear to overlie a tumor can be inkedTemplate:Ink note.
  • Initial cutting can be:
  • A longitudinal cut opposite to the tumor if it is relatively demarcated (by sight and/or palpation).
  • Transverse (cross-sectional) slicing, until reacing the tumor, particularly for circumferential tumors.
  • Measure the distance proximal and distal to the tumor.[1]
  • Note any accompanying "polyps".[1]
  • Describe the serosa, and whether there are any suspected tumor breakthroughs hereof.[1]
  • Evaluate the following either before or after slicing it up:[1]
  • Tumor size
  • The proportion of the circumference involved
  • Slice the tumor, either by transverse or longitudinal slicing.[1]
  • Review each slice and note the depth (in terms of anatomic layer, possibly with rough percentage thereof) and distance to the serosa or transverse resection margin for any tumor invasion and/or infiltration.[1]

Tissue selection

Should include:[1]

  • The tumor slices that show the deepest penetration. The slices should include tumor relation to the serosa or resection margin, as well as adjacent normal mucosa.
  • Proximal and distal resection margin, respectively. Take transverse slices except if the tumor is critically close to the margin, in which case it is advisable to take slices perpendicular to that margin, including both the tumor border and the resection margin.
  • Take slices of any other suspicious findings
  • Take a slice of the normal intestinal wall
  • Take slices from any adherent structures and/or organ parts
  • Carefully go through included mesentery for lymph nodes, and cut each in two parts.

Gross report

Should include:[1]

  • Dimensions of entire sample, as well as for the tumor
  • Distance to proximal and distal resection margins
  • Depth of tumor invasion and/or infiltration

  See also: General notes on reporting

Microscopy report

It should include:[1]

  • Tumor type[1]
  • Degree of differentiation[1]
  • Depth of growth and/or infiltration
  • Whether the resection is radical
  • Any breakthrough of the serosa and/or resection margin
  • Number of lymph nodes found
  • Number of them with metastases
  • Number of them with periglandular growth

Microscopic evaluation



  1. 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.

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  1. 1.00 1.01 1.02 1.03 1.04 1.05 1.06 1.07 1.08 1.09 1.10 1.11 1.12 Unless otherwise specified, refereence is: Monica Dahlgren, Janne Malina, Anna Måsbäck, Otto Ljungberg. Stora utskärningen. KVAST (Swedish Society of Pathology). Retrieved on 2019-09-26.

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