Difference between revisions of "Lung tumor"

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*'''Measure''' the specimen in 3 dimensions.
 
*'''Measure''' the specimen in 3 dimensions.
 
*Describe any included '''pleural surface''', including color, and any presence of granularity, adhesions, retraction, or tumor.
 
*Describe any included '''pleural surface''', including color, and any presence of granularity, adhesions, retraction, or tumor.
 +
*{{Moderate-begin}}[[Ink]] the surgical margin.{{Moderate-end}}
 
*Serially '''section''' the specimen. Describe the cut surface, including color and consistency, and any focal lesions.  
 
*Serially '''section''' the specimen. Describe the cut surface, including color and consistency, and any focal lesions.  
 
*Measure '''tumor size''' as a maximum diameter {{Moderate-begin}}or 3 dimensions{{Moderate-end}}
 
*Measure '''tumor size''' as a maximum diameter {{Moderate-begin}}or 3 dimensions{{Moderate-end}}
 
*Determine '''location''': Which lobe if applicable, and if it is peripheral, central or hilar.
 
*Determine '''location''': Which lobe if applicable, and if it is peripheral, central or hilar.
*'''Margin''' length to pleura and hilum/surgical margin. {{Moderate-begin}}In wedge resections, also measure the distance to the bronchial/vascular margin.{{Moderate-end}}
+
*'''Margin''' length to pleura and hilum/surgical margin.
 
*Any '''involvement''' of major bronchi or blood vessels.
 
*Any '''involvement''' of major bronchi or blood vessels.
 
*Any abnormal '''lymph nodes''', including hilar ones if available.
 
*Any abnormal '''lymph nodes''', including hilar ones if available.
 
Photograph all tumors.
 
Photograph all tumors.
 +
 +
===Gross report===
 +
{{Report-begin|fresh=yes|intraop=yes}} a wedge-shaped piece of lung which measures __ cm and has a staple line along one aspect measuring __ cm in length. The stapled surgical margin is inked black. The visceral pleura is mottled tan-pink and slightly puckered in the center. Cut sections show a tan, soft, tumor measuring __ cm in greatest dimension, located __ cm from the visceral pleura and __ cm from the surgical margin.  The remaining parenchyma is pink and spongy.{{Report-end}}
  
 
<gallery mode=packed heights=190>
 
<gallery mode=packed heights=190>

Revision as of 10:32, 17 March 2021

Author: Mikael Häggström [note 1]

Comprehensiveness

On this resource, the following formatting is used for comprehensiveness:

  • Minimal depth
  • (Moderate depth)
  • ((Comprehensive))

Presentations

Gross processing

In tumor resection:[1]

  • Measure the specimen in 3 dimensions.
  • Describe any included pleural surface, including color, and any presence of granularity, adhesions, retraction, or tumor.
  • (Ink the surgical margin.)
  • Serially section the specimen. Describe the cut surface, including color and consistency, and any focal lesions.
  • Measure tumor size as a maximum diameter (or 3 dimensions)
  • Determine location: Which lobe if applicable, and if it is peripheral, central or hilar.
  • Margin length to pleura and hilum/surgical margin.
  • Any involvement of major bronchi or blood vessels.
  • Any abnormal lymph nodes, including hilar ones if available.

Photograph all tumors.

Gross report

((A. Labeled - ___. The specimen is received fresh for intraoperative consultation and consists of)) a wedge-shaped piece of lung which measures __ cm and has a staple line along one aspect measuring __ cm in length. The stapled surgical margin is inked black. The visceral pleura is mottled tan-pink and slightly puckered in the center. Cut sections show a tan, soft, tumor measuring __ cm in greatest dimension, located __ cm from the visceral pleura and __ cm from the surgical margin. The remaining parenchyma is pink and spongy. (Representative sections are submitted for microscopic examination in __ cassettes.)

Microscopic evaluation

Medical imaging provides a major clue as to whether a lung tumor is benign or malignant, where lesions smaller than 2 cm are likely to be benign, whereas lesions larger than 2 cm are malignant (that is, lung cancer) in 85% of cases.[2]

Subsequently distribution of benign tumors and lung cancers, respectively, are as follows:[2]

Lung cancers by relative incidence.

Benign lung tumors:

  • Hamartomas - 76%
  • Benign fibrous mesothelioma/solitary fibrous tumor (SFT) - 12.3%
  • Inflammatory pseudotumor (IPT) - 5.4%
  • Lipoma - 1.5%
  • Leiomyoma - 1.5%
  • Other - 3.3%

Gallery of lung cancers

Notes

  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.

Main page

References

  1. . Pulmonary pathology grossing guidelines. Retrieved on 2021-03-17.
  2. 2.0 2.1 Alain C. Borczuk (2008). "Benign Tumors and Tumorlike Conditions of the Lung ". Archives of Pathology & Laboratory Medicine 132 (7). Archived from the original. . 
  3. Dr Nicholas Turnbull, A/Prof Patrick Emanual (2014-05-03). Squamous cell carcinoma pathology. DermNetz.

Image sources