Auto text: Insert Pancreas Distal”

Triage

1. Orient the specimen, which usually consists of the pancreatic tail with or without the spleen.
2. Ink the proximal pancreatic margin.
3. Measure the portion of pancreas and the attached spleen.
4. Serially section all entities at 1 cm intervals.  Cut pancreas perpendicular to the main pancreatic duct.
5. Fix in formalin or gross fresh.

Gross

1. Shave, serially section and submit proximal pancreatic resection margin.
2. Describe and measure the pancreas and tumor (each in three dimensions).
3. Describe whether lesion involves the main pancreatic duct and/or the side ducts.
4. If untreated: Submit at least 1 section per centimeter of tumor.
5. If treated: Submit entire visualized lesion.
6. If IPMN based on clinical impression/pre-operative cytology: submit the entire lesion.
7. The spleen may be included in the specimen because:
   • Resection of the tumor required its incidental removal
   • The splenic capsule was accidentally lacerated
   • Tumor invades the hilar soft tissue
8. Document/describe any capsular laceration and take section of this area. Take representative sections of spleen (peripheral and central in the same cassette) if it was removed incidentally. Sample the hilar soft tissue if involved by tumor. Also remember that any lymph nodes in the hilar soft tissue should be submitted.
9. Submit all peripancreatic lymph nodes.