Uterus, Endometrial Hyperplasia

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  1. Weigh specimen and measure:
    • 3 dimensions of uterus (C-C, Fundus-LUS, A-P).
    • 3 dimensions of cervix (face and length).
    • Shape, diameter of os.
    • Ovaries (3D) and fallopian tubes (2D), if present.
  2. Identify anterior and posterior sides and note quality of serosa:
    1. The peritoneal reflection extends further inferiorly on the posterior side and is pointed.
    2. The peritoneal reflection on the anterior side is rounded.
    3. The tube is anterior to the ovary.
  3. Bisect uterus through 3:00 and 9:00 positions.
  4. Measure endocervical canal and endometrial cavity in 2 dimensions, and thickness of endometrium and myometrium.
  5. Measure any lesions (whorled nodules, polyps, etc).
  6. Partially slice entire endomyometrium transversely at 1 cm intervals.
  7. Place in formalin.


  1. Take 2 longitudinal sections through ecto/endocervix (1 anterior and 1 posterior).
  2. Take 2 longitudinal sections through upper endocervix/lower uterine segment (1 anterior and 1 posterior), immediately adjacent to sections taken from cervix.
  3. Take 4 full-thickness representative sections of endomyometrium (2 anterior and 2 posterior).
  4. Transversely section the remaining anterior and posterior endomyometrium (~1 cm thick).  Submit the entire endometrium from LUS to fundus, maintaining orientation.
  5. Submit any additional pathology (leiomyomas, polyps in their entirety, etc).
  6. Submit 2 representative sections of each ovary.
  7. Submit entire fimbriae (longitudinally bisected, 1-2 cassettes maximum) and 2 representative cross-sections on each side.
  8. Submit adnexa entirely per SEE-FIM protocol if patient has a history of breast cancer.

Updated 6-6-2022 SRR

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