Blocks for histology Figure 283 radical nephrectomy

• separately label each block and clearly document the exact site of origin.

• sample margin blocks (perinephric fat, ureter, renal vein and artery). Ureteric and vessel blocks may be conveniently taken prior to dissection of the main specimen.

• sample to show relationships between tumour and the radial margin; tumour and adrenal gland (upper pole tumours); tumour and renal pelvis/sinus and surrounding renal parenchyma.

• sample one block from each tumour area that differs in colour.

• one block of tumour per 2 cm of tumour diameter is probably sufficient (minimum of four blocks).

• count and sample all lymph nodes.

• sample the adrenal gland when present (one block).

• sample the surrounding kidney and particularly if any nodules are seen (adenoma, adrenal rests or multifocal carcinoma).

• in transplant nephrectomies, blocks should be taken serially (from without in) of the hilar vessels to examine the nature of the renal vein and artery.

• in nephrectomies for benign disease, samples to be taken include any abnormal area and one random from otherwise normal parenchyma.

Tumour expanding capsule and abutting perinephric fat

Tumour expanding capsule and abutting perinephric fat

Tumour and radial margin

Tumour, cortex and perirenal fat to include radial margin or Gerota's fascia

Figure 28.3. Blocking of a nephrectomy specimen for upper pole renal carcinoma.

Tumour and radial margin

Tumour, cortex and perirenal fat to include radial margin or Gerota's fascia

Figure 28.3. Blocking of a nephrectomy specimen for upper pole renal carcinoma.

Normal kidney and pelvis

Normal kidney and pelvis

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