Retroperitoneal and pelvic lymph node dissections

• such specimens will often be submitted in multiple parts, each representing a specific anatomical nodal group and it is important that this information is preserved in the final histological report.

• weigh (g) each specimen and dissect out recognisable lymph nodes. The maximum dimension (cm) of the largest node should be recorded. Smaller lymph nodes may be submitted intact; larger nodes can be bisected or serially sectioned and then submitted in a separate tissue block. It is important to record on the final histology report the number of nodes identified. For example, in cervical carcinoma retrieval of 10 uninvolved lymph nodes is considered necessary for assignment to the pNO category.

• RPLNDs post-chemotherapy for testicular germ cell tumours present particular challenges. There may be a recognisable tumour mass present. The circumferential margin is inked to assess the adequacy of excision. Multiple representative sections are taken to ensure that any residual viable areas of embryonal carcinoma or yolk sac tumour are detected (Figure 35.2).

Sample multple blocks of cystic and solid areas

Figure 35.2. Blocking of a retroperitoneal lymph node dissection (RPLND) specimen.

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