Uterus, Lynch Syndrome

Auto text: “Insert Uterus Lynch Syndrome”

Triage

  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. Most of these cases should be grossed on same day of receipt.

Gross

  1. Obtain longitudinal sections through cervix, anterior and posterior sides.
  2. Transversely section the endomyometrium (including the LUS) and take 4-6 full-thickness sections of (1 anterior LUS, 1 posterior LUS, 2 anterior endomyometrium and 2 posterior endomyometrium).
  3. Submit the remaining LUS, endometrium, and inner myometrium from “LUS” to fundus, maintaining orientation.
    • Multiple sections can be placed in a single cassette.
  4. Submit any additional pathology (leiomyomas, polyps in their entirety, etc).
  5. Submit entire ovaries and fallopian tubes per SEE-FIM protocol.
    1. Amputate the distal 2 cm (fimbriae) and section parallel to the long axis.
    2. Section the remainder of tube transversely in 2-3 mm intervals.

Updated 6-22-2020 SRR

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