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 Measure the dimensions of organ.
 Weigh it if it is obviously abnormal.
 During the reproductive period,
 Average size is 4 × 2 × 1 cm.
 Average weight is 5–8 g.
 After menopause, they shrink to one half or less of
this size.
 If the specimen received
is:
a Normal-sized or nearly
normal-sized organ: bivalve
the ovary with a cut
through its longest
dimension and fix for
several hours.
b Enlarged organ: make
several cuts at distance of 1
cm apart and fix for several
hours.
 External surface smooth or irregular?
 Capsule: thickened? adhesions?
haemorrhage? rupture?
 Cystectomies are usually performed for benign
lesions or in women with ovarian masses who
wish to preserve their fertility.
 If ovarian cystectomy specimen is received, after
weighing and measuring the specimen , examine
the external surface for evidence of rupture.
 In absence of rupture, place the cyst in a
container, and carefully make a small incision in
the wall to allow its contents to be drained.
 Note the colour and consistency of the cyst
fluid.
 Clear fluid – Serous tumour.
 Fluid to viscous material of mucoid nature –
Mucinous tumour.
 Thick sebaceous material along with hairs,
teeth etc - Dermoid cyst.
 Continue the incision with a pair of scissors to
expose the entire inner surface.
 In cystectomy specimen:-
 Examine the surfaces of the cysts for
evidence of granularity, nodules, or papillary
projections.
 The thickness of the cyst walls should also be
recorded.
Tumor :
 Size
 External surface
 Smooth or papillary?
 Solid or cystic?
Document area of each
separately, if both are
present in a specimen.
 Content of cystic mass
 Hemorrhage, necrosis, or
calcification?
Papillary projection
within the cyst
Solid area
Cystic area
1 For incidental oophorectomies: one sagittal
section of each entire ovary, labeled as to side.
2 For cysts: up to three sections of cyst wall
(particularly from areas with papillary
appearance).
3 For tumors: three sections or one section for
each centimeter of tumor, whichever is greater;
also, one section of non-neoplastic ovary, if
identifiable
 If the ovary and fallopian tube were removed
as a prophylactic procedure in a woman with
a family history of ovarian or breast
carcinoma, the entire ovary and fallopian
tube should be submitted.
Follicular cysts
Cyst diameter exceeding 2.5 cm
Stein–Leventhal syndrome
Numerous follicular cysts
The luminal content is
typically hemorrhagic
corpus luteum cyst. Endometrosis
Uni-/ multiloculated cysts
filled with clear fluid
Serous
cystadenoma Increased papillary projections
within cyst
Borderline serous
cystadenoma
- irregular tumour mass
- ↑ solid/ papillary
- necrosis/ haemorrhage
Serous cystadenocarcinoma
Mucinous cystadenoma
Uni-/ multiloculated cysts (filled with
mucinous material)
Borderline mucinous cystadenoma
-multiloculated
cysts
-papillae
Mucinous cystadenocarcinoma
Necrosis/
Haemorrhage
- Solid /cystic / combination
-Cyst content- haemorrhagic usually
Endometrioid carcinoma Clear cell
adenocarcinoma
- Spongy, often cystic
-Unilocular cysts with solid nodules
- Mostly solid
- well circumscribed
- On cut- firm, white/yellowish white
Brenner tumour
On cut- predominantly solid with areas of
haemorrhage, necrosis (+) cartilage/bone
ImmatureTeratoma
Mature teratoma
cheesy sebaceous material
Hair
Teeth
Struma ovarii
-Thyroid tissue predominantly
- solid, gelatinous or cystic
- Locules
- brown/ greenish brown fluid
Carcinoid
tumour
Typically firm, tan to yellow, solid or cystic
Encapsulated,smooth, lobulated surface
On cut-
solid, fleshy with foci of
haemorrage & necrosis
-Smooth, glistening
external surface.
-On cut-variegated
Yolk sac tumour Embryonal carcinoma
External surface- smooth & glistening
Cut surface- solid, variegated with extensive
haemorrhage & necrosis
Adult Granulosa cell tumour
-encapsulated
-uniformly solid/cystic/ combination
- on cut:solid, yellow areas, haemorrhage
Juvenile Granulosa cell tumour
Solid,lobulated On cut:solid with cystic
Thecoma
-Encapsulated, Firm
- on cut: solid, yellow with white foci
Fibroma
Solid, lobulated
-On cut- firm, uniformly white
-cyst formation/ calcification/ haemorrhage/
necrosis
Krukenberg tumour Solid, multinodular
Metastasis of
large bowel
adenocarcinoma
solid, nodular
Presented by- Dr. Monika Nema

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Grossing procedure for ovary

  • 1.
  • 2.  Measure the dimensions of organ.  Weigh it if it is obviously abnormal.  During the reproductive period,  Average size is 4 × 2 × 1 cm.  Average weight is 5–8 g.  After menopause, they shrink to one half or less of this size.
  • 3.  If the specimen received is: a Normal-sized or nearly normal-sized organ: bivalve the ovary with a cut through its longest dimension and fix for several hours. b Enlarged organ: make several cuts at distance of 1 cm apart and fix for several hours.
  • 4.  External surface smooth or irregular?  Capsule: thickened? adhesions? haemorrhage? rupture?
  • 5.  Cystectomies are usually performed for benign lesions or in women with ovarian masses who wish to preserve their fertility.  If ovarian cystectomy specimen is received, after weighing and measuring the specimen , examine the external surface for evidence of rupture.  In absence of rupture, place the cyst in a container, and carefully make a small incision in the wall to allow its contents to be drained.
  • 6.  Note the colour and consistency of the cyst fluid.  Clear fluid – Serous tumour.  Fluid to viscous material of mucoid nature – Mucinous tumour.  Thick sebaceous material along with hairs, teeth etc - Dermoid cyst.  Continue the incision with a pair of scissors to expose the entire inner surface.
  • 7.  In cystectomy specimen:-  Examine the surfaces of the cysts for evidence of granularity, nodules, or papillary projections.  The thickness of the cyst walls should also be recorded.
  • 8. Tumor :  Size  External surface  Smooth or papillary?  Solid or cystic? Document area of each separately, if both are present in a specimen.  Content of cystic mass  Hemorrhage, necrosis, or calcification? Papillary projection within the cyst Solid area Cystic area
  • 9. 1 For incidental oophorectomies: one sagittal section of each entire ovary, labeled as to side. 2 For cysts: up to three sections of cyst wall (particularly from areas with papillary appearance). 3 For tumors: three sections or one section for each centimeter of tumor, whichever is greater; also, one section of non-neoplastic ovary, if identifiable
  • 10.  If the ovary and fallopian tube were removed as a prophylactic procedure in a woman with a family history of ovarian or breast carcinoma, the entire ovary and fallopian tube should be submitted.
  • 11. Follicular cysts Cyst diameter exceeding 2.5 cm Stein–Leventhal syndrome Numerous follicular cysts
  • 12. The luminal content is typically hemorrhagic corpus luteum cyst. Endometrosis
  • 13. Uni-/ multiloculated cysts filled with clear fluid Serous cystadenoma Increased papillary projections within cyst Borderline serous cystadenoma - irregular tumour mass - ↑ solid/ papillary - necrosis/ haemorrhage Serous cystadenocarcinoma
  • 14. Mucinous cystadenoma Uni-/ multiloculated cysts (filled with mucinous material) Borderline mucinous cystadenoma -multiloculated cysts -papillae Mucinous cystadenocarcinoma Necrosis/ Haemorrhage
  • 15. - Solid /cystic / combination -Cyst content- haemorrhagic usually Endometrioid carcinoma Clear cell adenocarcinoma - Spongy, often cystic -Unilocular cysts with solid nodules
  • 16. - Mostly solid - well circumscribed - On cut- firm, white/yellowish white Brenner tumour
  • 17. On cut- predominantly solid with areas of haemorrhage, necrosis (+) cartilage/bone ImmatureTeratoma Mature teratoma cheesy sebaceous material Hair Teeth
  • 18. Struma ovarii -Thyroid tissue predominantly - solid, gelatinous or cystic - Locules - brown/ greenish brown fluid Carcinoid tumour Typically firm, tan to yellow, solid or cystic
  • 19. Encapsulated,smooth, lobulated surface On cut- solid, fleshy with foci of haemorrage & necrosis
  • 20. -Smooth, glistening external surface. -On cut-variegated Yolk sac tumour Embryonal carcinoma External surface- smooth & glistening Cut surface- solid, variegated with extensive haemorrhage & necrosis
  • 21. Adult Granulosa cell tumour -encapsulated -uniformly solid/cystic/ combination - on cut:solid, yellow areas, haemorrhage Juvenile Granulosa cell tumour Solid,lobulated On cut:solid with cystic
  • 22. Thecoma -Encapsulated, Firm - on cut: solid, yellow with white foci Fibroma Solid, lobulated -On cut- firm, uniformly white -cyst formation/ calcification/ haemorrhage/ necrosis
  • 23. Krukenberg tumour Solid, multinodular Metastasis of large bowel adenocarcinoma solid, nodular
  • 24. Presented by- Dr. Monika Nema