Wedge Resections or Cornish Pastie

• consist of a triangular segment of lung and pleura with two staple lines at the margin (Figure 38.2).

• palpate the specimen to locate the lesion.

• record the dimensions(cm).

• describe the pleura.

• inflate with a syringe of formalin. A disadvantage of inflation fixation is that free cells may be cleared from consolidated alveoli so that diagnoses such as desquamative interstitial pneumonia (DIP) are obscured. Measure the length of the margin. Cut off the staple line as closely as possible. The cut surface of the lung can be taken en face or perpendicularly. The open surface is inked.

• ink the pleural surface over the lesion.

• serially transverse section at 3 mm intervals.

• describe the lesion - size, colour, pleural involvement, distance (mm) from margin.

• describe the remainder of the lung.

• take representative sections of any lesion, of its relationship to the pleura and uninvolved lung, and the closest margin.

• if the lung disease is diffuse submit the vast majority of the specimen for histology.

Pleura

Pleura

1. Locate the lesion and paint the overlying pleura

2. Cut off the stapled margin

3. Paint the cut parenchymal margin and serially slice perpendicular to it

4. Block tumour in relation to lung, pleura and parenchymal margin

Figure 38.2. Blocking a wedge resection of lung.

1. Locate the lesion and paint the overlying pleura

2. Cut off the stapled margin

3. Paint the cut parenchymal margin and serially slice perpendicular to it

4. Block tumour in relation to lung, pleura and parenchymal margin

Figure 38.2. Blocking a wedge resection of lung.

0 0

Post a comment