larynx

LARYNGECTOMY SPECIMEN

Specimen identification:

            Type of specimen (total, supraglottic or hemi-laryngectomy)

            Additional tissues: base of tongue, pharynx, thyroid gland, neck dissection)

            Size (3 measurements)

 

Primary Pathology

            Size (3 dimensions, including greatest depth of invasion)

Location (right/left), glottic, supraglottic (specify subsite), subglottic, transglottic, pyriform sinus)

Cartilage invasion, extralaryngeal soft tissue invasion

            Margins (aryepiglottic folds, epiglottis, pharyngeal, trachea, anterior soft tissue)

 

Secondary Pathology

            Leukoplakia, stoma, cysts, thyroid nodules.

 

Ink Code:

Anterior margin=

 

Cassette Description

 

EXAMPLE DICTATION:

"Total laryngectomy" Received in formalin in a medium container is a 7.5 x 7 x 6.5 cm total laryngectomy specimen with attached 4.5 x 5 x 1 cm base of tongue and soft tissue. Photos taken.

 

Two lesions are identified. The first is a poorly-circumscribed, ulcerative firm white-tan mass (3.5 x 2.3cm, greatest depth of invasion=0.6cm) within the right base of tongue soft tissue—0.4 cm from the superior resection margin, 1 cm from the right resection margin, 1.1cm from the left resection margin. The second lesion is a similar poorly circumscribed firm white mass (2x1.3cm, greatest depth of invasion=0.5cm) involving the anterior commissure, right epiglottis and right aryepiglottic fold.  The second lesion is 0.9cm from the right pyriform sinus and 5.5 cm from the tracheal margin.

 

The left aryepiglottic fold is densely fibrotic (1.5x0.7 cm) with multiple metal clips consistent with prior surgery.  Thyroid and cricoid cartilage are unremarkable.  No thyroid gland or lymph nodes are identified.

 

Inking Code

Deep soft tissue margin=Blue

False margins (frozen/surgically designated)=Yellow

 

Cassette Description:

1A-D. Superior resection margin to first mass submitted from right to left. (ss)

(Please see photo)

1E. Superior mass to left resection margin. (ss)

1F. Superior mass to right resection margin. (ss)

1G. Tracheal margin. (1ns)

1H. Supraglottic mass to right pyriform sinus. (ns)

1I. Right aryepiglottic fold. (ns)

1J-K. Supraglottic mass. (ns)

1L. Closest left pyriform sinus area. (ns)

1M. Fibrotic left aryepiglottic fold. (ns)

1N. Cricoid cartilage to right supraglottic mass. (1ss after

decalcification)

1O. Thyroid cartilage to supraglottic mass. (1ss after

decalcification)