Grossing templates
Breast The specimen is received in a container labelled with the patient's name, who has the initials "[____]" and the specimen site "[83590]". Ischemic time range: [less than 1 hour, 1 to 2 hours, greater than 2 hours] Fixation time at time of grossing: [Less than 72 hours, Greater than 72 hours] [The specimen was inked as follows:] [The specimen was inked green.] Type of specimen: [mastectomy with/without axilla; excisional biopsy; segmental biopsy; with/without chest wall muscle] Overall dimensions: [___] cm medial to lateral x [____] cm superior to inferior x [____] cm superficial to deep Skin: ["N/A" if not present; nipple present, scar, dimpling, puckering, unremarkable, uninvolved] Skin dimensions: [____] cm medial to lateral x [____] cm superior to inferior Tumour Dimensions: [____] cm medial to lateral x [____] cm superior to inferior x [____] cm anterior to posterior Location: [Quadrant or aspect] Characteristics: [well/poorly circumscribed; necrosis; hemorrhage; colour, calcification, include hemorrhage from previous biopsy] Distance to skin: [___] cm Distances to nearest margins: [breast margins, color margins] Non-tumoural mammary tissue: [____] Axillary contents included: [No, Yes, measuring cm] Appearance of lymph nodes: [___] Other: [specimen photographed, specimen mapped] Representative sections: [1 section of nipple if unremarkable, 1 section of skin closest to lesion]
Breast margins: [if < 1.0 submit twice, for mastectomy posterior always, other margins if <2.0] cm - deep margin [____] cm - medial margin [____] cm - lateral margin [____] cm - superior margin [____] cm - inferior margin [____] cm - superficial margin [____] cm - nipple margin
Color margins: [if < 1.0 submit twice] cm - black margin [____] cm - yellow margin [____] cm - orange margin [____] cm - red margin [____] cm - blue margin [____] cm - green margin [____] cm - nipple margin
QCH Kidney template 182843 KID TUMOR TEMPLATE The specimen is received in a container labelled with the patient's name whose initials are "[]" and "[]". Resection Specimen: [] (wedge biopsy, partial nephrectomy ,radical nephrectomy, Nephroureterectomy) Overall dimensions: [] x [] x [] cm Weight: [] g (kidney and fat overlying the mass) Kidney dimensions: [] x [] x [] cm Tumor location: [] (upper/lower pole; hilum) Tumor dimensions: [] x [] x [] cm Tumor characteristics: [] (color; hemorrhage; cysts; necrosis, % necrosis) Extension into perinephric fat: [] (yes/no) Extension of tumor into renal pelvic fat (yes/no) Distance of tumor to overlying perinephric fat (painted surface): [] cm Distance of tumor to ureteric resection margin: [] cm Distance of tumor to bladder cuff resection margin: [] cm Renal vein invasion: [] (yes/no) Non-neoplastic renal parenchyma: [] (unremarkable; capsular surface; scars; cysts; other nodules) Calyces, pelvis: [] Ureter: [] (invasion by tumor – if TCC, invasion of renal parenchyma, distance to ureteric resection margin, ?multicentricity; calculi; hemorrhage; pelvic/calyceal dilatation) Adrenal gland: [] (present/absent; dimensions; abnormalities) Lymph nodes: [] Other: [] (specific description, as appropriate; eg. TCCinvasion into renal pelvis)