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Histopathology Specimens Histopathology Specimens 1 1 1 1 i Springer London Berlin Heidelberg New York Hong Kong Milan Paris Tokyo ii Derek C. Allen and R. Iain Cameron (Eds) Histopathology Specimens Clinical, Pathological and Laboratory Aspects 1 with 129 figures 1 1 1 iii Derek C. Allen, MD, FRCPath Consultant Pathologist, Histopathology Laboratory, Belfast City Hospital Trust, Belfast UK R. Iain Cameron, MB, BCh FRCS Specialist Registrar in Histopathology, Histopathology Laboratory, Belfast City Hospital Trust, Belfast UK British Library Cataloguing in Publication Data Histopathology specimens : clinical, pathological and laboratory aspects 1. Histology, Pathological – laboratory manuals I. Allen, Derek C. (Derek Creswell) II. Cameron, R. Iain 616′. 07583 ISBN 1852335971 Library of Congress Cataloging-in-Publication Data A catalog record for this book is available from the Library of Congress Apart from any fair dealing for the purposes of research or private study, or criticism or review, as permitted under the Copyright, Designs and Patents Act 1988, this publication may only be reproduced, stored or transmitted, in any form or by any means, with the prior permission in writing of the publishers, or in the case of reprographic reproduction in accordance with the terms of licences issued by the Copyright Licensing Agency. Enquiries concerning reproduction outside those terms should be sent to the publishers. ISBN 1–85233–597–1 Springer-Verlag London Berlin Heidelberg a member of BertelsmannSpringer Science+Business Media GmbH © Springer-Verlag London Limited 2004 The use of registered names, trademarks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant laws and regulations and therefore free for general use. Product liability: The publisher can give no guarantee for information about drug dosage and application thereof contained in this book. In every individual case the respective user must check its accuracy by consulting other pharmaceutical literature. Typeset by Florence Production Ltd., Stoodleigh, Devon Printed and bound in the United States of America 28/3830–543210 Printed on acid-free paper SPIN 10867763 iv In memory of Dr Heather Elliott 1 1 1 1 v Preface The reorganisation of cancer services has emphasised the importance of histopathology speci- mens in patient management and highlighted the pivotal role the histopathologist has as part of the multidisciplinarian team. The specimens require careful, detailed and consistent handling to ascertain multiple prognostic factors relevant to appropriate management of individual patients. This must stem from a background knowledge of the relevant anatomy, clinical presentation and investigation of disease, the common pathological processes and how they affect both tissues and 1 patient outlook. Specimen handling ought to reflect investigative techniques, e.g., CT/MRI scan- ning and the operative surgical procedures used. Histopathology reports must be prompt and accurate using classifications and documenting locoregional spread that match therapeutic options and prognostic groups. The multidisciplinarian team extends to the histopathology laboratory to include medical pathologists, biomedical scientists and secretarial staff. The purpose of this book is to educate and better equip all those involved in the histopathology specimen process for their task. An emphasis is placed on a standardised approach to specimen handling and reporting to achieve consistently high quality. Practical outworking of this process involves informed clinicopatho- logical correlation, active communication, supervision and feedback within and between the 1 clinical and laboratory teams. Hopefully the reader will find the content pragmatic and practicable representing our current practice. No one method is exclusively right – other options exist and are of equal merit given due care and consistency. What is certain is that techniques will inevitably change in the light of new developments and will be incorporated into the histopathology specimen process. The authors gratefully acknowledge the use of illustrations from P. Hermanek, R.V.P. Hutter, L.H. Sobin, G. Wagner, Ch. Wittenkind (eds). TNM Atlas: Illustrated Guide to the TNM/pTNM Classification of Malignant Tumours. 4th edn. Berlin Heidelberg New York. Springer 1997, and, Allen D C. Histopathology Reporting – Guidelines for Surgical Cancer. London. Springer 2000. Grateful appreciation is expressed to Melissa Morton (medical editor), Eva Senior and the staff 1 at Springer, and all our colleagues in the Belfast City Hospital and Royal Victoria Hospital Histopathology Laboratories. Mrs Debbie Greene provided particular secretarial expertise. Acknowledgement is made of Mr Brian Duggan (urological specialist registrar) for his clinical comments on the urology specimens section. Derek Allen, Iain Cameron Belfast 1 vii Contents Contributors . xiii Introduction . xv Gastrointestinal Specimens Derek C Allen, R Iain Cameron 1 General comments . .3 1. Oesophagus . .12 2. Stomach . 23 3. Pancreas, Duodenum, Ampulla of Vater and Extrahepatic Bile Ducts. 35 4. Small Intestine . 51 5. Colorectum . .65 6. Appendix . 86 7. Anus . 93 8. Gall Bladder . 100 1 9. Liver . 107 10. Abdominal Wall, Umbilicus, Hernias, Omentum and Peritoneum . 119 Breast Specimens TF Lioe 11. Breast . 127 Head and Neck Specimens Séamus S Napier with clinical comments by David S Brooker, Derek J Gordon, 1 Richard W Kendrick, William J Primrose and Colin FJ Russell 12. Nasal Cavities and Paranasal Sinuses . 143 13. Lips, Mouth and Tongue . 151 14. Maxilla, Mandible and Teeth . 164 15. Pharynx and Larynx . 174 16. Salivary Glands . 188 17. Thyroid Gland . 197 18. Parathyroid Glands . 206 1 19. Neck – Cysts, Tumours and Dissections . 210 ix x Contents Eye, Muscle and Nerve Specimens Roy W Lyness 20. Eye, Muscle and Nerve Specimens (including rectal biopsy for Hirschsprung’s disease) . 221 Gynaecological Specimens W Glenn McCluggage 21. Ovary . 235 22. Fallopian Tube . 244 23. Uterus . 249 24. Cervix . 259 25. Vagina . 268 26. Vulva . 273 27. Placenta . 279 Urological Specimens Declan M O’Rourke, Maurice B Loughrey 28. Kidney, Renal Pelvis and Ureter . 285 29. Bladder . 300 30. Prostate . 311 31. Urethra . 323 32. Testis, Epididymis and Vas . 330 33. Penis . 342 Pelvic and Retroperitoneal Specimens Maurice B Loughrey, Damian T McManus 34. Pelvic Exenteration Specimens . 353 35. Retroperitoneum . 359 36. Adrenal Gland . 365 Skin Specimens Maureen Y Walsh 37. Skin Specimens . 375 Cardiothoracic Specimens and Vessels Kathleen M Mulholland 38. Lung . 393 39. Pleura . 406 40. Mediastinum . 412 41. Heart . 420 42. Vessels . 428 x Contents xi Osteoarticular and Soft Tissue Specimens Richard I Davis 43. Joint Space, Bone, Soft Tissues and Special Techniques . 437 Haemopoietic Specimens Lakshmi Venkatraman, W Glenn McCluggage, Peter A Hall 44. Lymph Nodes, Spleen and Bone Marrow . 453 Miscellaneous Specimens Damian T McManus 45. Miscellaneous Specimens and Ancillary Techniques . ..
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