Blocks for histology Figure 284 nephroureterectomyureterectomy

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

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

• one block of tumour per 1 cm of tumour diameter is probably sufficient (minimum of four blocks).

• sample to show the relationships between tumour and renal pelvis; tumour, renal pelvic wall and peripelvic fat; tumour, cortex and perirenal fat.

• in renal pelvic tumours sample areas of unremarkable and abnormal mucosa away from the tumour in the renal pelvis and ureter.

• with ureteric tumours, serially section the tumour transversely at 3 mm intervals and sample a minimum of three blocks to assess the deepest point of invasion.

• if ureteric tumour is not seen grossly, sample and correspondingly label unremarkable and abnormal mucosal areas.

• transverse sections of the distal ureteric/bladder cuff margin.

• count and sample all lymph nodes.

• additional sections should include renal pelvis, renal artery, renal vein and ureter.

Normal kidn and pel

Tumo and pe

Normal kidn and pel

Tumo and pe

Tumour and renal pelvis

Tumour and renal pelvic wall with peripelvic fat

Transverse sections of ureteric tumour

Tumour and renal pelvis

Tumour and renal pelvic wall with peripelvic fat

Transverse sections of ureteric tumour

Figure 28.4. Blocking of a nephroureterectomy for multifocal ureteropelvic transitional cell carcinoma.

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

• sample the surrounding kidney.

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