Dictation Template: Nephrectomy Specimen for Pediatric Tumors

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Dictation Template: Nephrectomy Specimen for Pediatric Tumors

The specimen is received fresh, labelled with the patient’s name, and designated on the requisition as “[ ].” It consists of a [ ] g, [ ] cm nephrectomy specimen with up to [ ] cm attached perinephric adipose tissue. Extending from the renal pelvis is a ureter measuring [ ] cm in length by [ ] cm in diameter. The distal ureter, renal artery, and renal vein are patent and devoid of gross tumor [or there is a __ cm red-tan blood clot / friable structure present within the lumen of the renal vein]. The outer surface is inked black and the specimen is bisected. Upon bisection, the kidney measures [ ] cm. There is a [ ] cm [circumscription, color, texture] tumor located [in the upper pole, lower pole, central]. The tumor is [ ] cm from the renal pelvis / or invades into the renal sinus adipose tissue / renal vein. [The renal sinus appears uninvolved.] It [does / does not] grossly invade into the perinephric fat and extends to [ ] cm from the inked soft tissue surface. The uninvolved renal parenchyma is tan-brown with a [ ] cm cortex and a well-defined cortico-medullary junction. [There are ill-defined, firm, pale areas are present in the superficial cortex.] The hilar and surrounding adipose tissues are sectioned and no lymph nodes are identified. [ # perihilar lymph node candidates are identified measuring __ and __ cm in the greatest dimension.] Adrenal gland [is present / not present and is unremarkable]. There are 3 portions of tumor and 1 portion of adjacent renal parenchyma. They are snap-frozen for Biorepository. The specimen is photographed.
Representative sections are submitted as follows:
  • [ ]: Sections of vascular margins, en face (contains origin of embolus or thrombus, if present)
  • [ ]: Section of the distal ureteral margin, en face
  • [ ]: Sections of tumor according to the map provided (one section per cm of the tumor’s largest dimension)
  • [ ]: Tumor closest to inked soft tissue margin (transition between tumor surface and Gerota's fascia)
  • [ ]: Sections of tumor and adjacent kidney interface
  • [ ]: One section of each tumor nodule in cases with multicentric tumors
  • [ ]: Uninvolved renal parenchyma away from tumor (contains pale, firm areas for potential nephrogenic rests)
  • [ ]: Sections of renal sinus including vessels
  • [ ]: Sections of renal pelvis and calyces
  • [ ]: Lymph nodes
  • [ ]: Adrenal gland
(Grossed by [Prosector’s Name])

Diagram for Wilms tumor mapping.