Many of these grossing templates were made with generous help from Dr. Zarrin Hossein-Zadeh. Others are based on templates from institutions I’ve practiced at. For some, you’ll see that there are different versions/options. As with all templates, these must be customized for each case–no two cases are the same!

PLACENTA

PLACENTA-SINGLETON

Received without fixative labeled with the patient’s name “[ ]” and designated “placenta” is an [oval/round/triangular/irregular] placenta weighing [x] g (trimmed weight) and measuring [ x x ] cm. The membranes have a [marginal/circummarginate/circumvallate] insertion, are [color] and [translucent/opaque/discolored]. The attached [tan-white] umbilical cord measures [?] cm in length, [? X ?] cm in width, contains [three/two] blood vessels on cross-section and has a [central/para central or marginal/marginal/velamentous/furcate] insertion [if velamentous, measure distance from disc edge]. Spiral configuration of the umbilical cord is noted without knots or other focal abnormalities. The fetal surface is smooth and glistening/ exhibits an irregular subchorionic patch or cyst measuring [(measure subchorionic patches/cysts if present)], covering approximately [%] of the fetal surface. The maternal surface is [intact/lacerated/partially fragmented] with [complete/incomplete] cotyledons. Sectioning reveals dark red parenchyma / sectioning reveals [few/multiple] lesions, measuring [ x x x ] located at [ ] from disc edge and involving [%] of placenta disc. Accessory lobe [is/is not] present [measures (cm) and is located (cm) from disc edge] with intact/disrupted vasculature.

Representative sections are submitted in [4] cassettes as follows: [A1 = cord, membranes; A2-A3 = representative sections of central aspect of placenta; A4 = section from area of lesion]

Placenta Singleton, Option 2

One specimen is received *** (fresh/in formalin) labeled with the patient’s name and medical record number, consisting of a placenta with attached umbilical cord and fetal membranes.

The *** (color) umbilical cord measures *** cm in length by *** cm in maximum diameter. It contains a normal amount of coiling. It inserts *** (centrally/eccentrically), *** cm from the disc margin and contains *** vessels on cut section. No true knots, edema, or other lesions are identified.

The *** (translucent/color) fetal membranes attach normally at the disc margin. The round placental disc weighs *** grams and measures *** x *** x *** cm. The fetal surface is *** (color), with a normal dispersion of the chorionic plate vessels. No thrombi are identified. The maternal surface is intact with no missing cotyledons. Adherent blood clot is identified, measuring *** x *** x *** cm, in aggregate. Serial sectioning through the placental disc at one centimeter intervals reveals spongy, dark red parenchyma with no lesions.

Representative sections are submitted as follows:

A1. umbilical cord, fetal end, and membrane rolls

A2. umbilical cord, placental end, and chorionic plate section near cord insertion

A3. placenta, central, full thickness section

A4. placenta, full thickness section

(A5 onward—any lesions identified)

PLACENTA-TWIN

Twin placenta-one disc

Received without fixative labeled with the patient’s name “[ ]” and designated “[ ]” is an [oval/round/triangular/irregular] fused placenta disc weighing [x] g (trimmed weight) and measuring [ x x ] cm with a [central/eccentric] dividing membrane. The dividing membrane is [tan-pink and translucent/dusky and congested]. Twin [A] is clinically identified by [one/two] cord clamps and twin [B] is designated by [one/two] cord clamps.

Placenta A:

Umbilical cord [A] is [ ] cm in length, [ ] cm in diameter, contains [two/three] blood vessels on cross-section and has a [central/para central or marginal insertion, marginal/velamentous/furcate] insertion. Spiral configuration of the umbilical cord is noted without knots or other focal abnormalities. The fetal membranes are [color], [translucent/opaque] and have [marginal/circummarginate/circumvallate] insertions. The placental portion of disc A measures [ x x ]. The fetal surface is [blue-gray] with [distinct vascular zones/indistinct vascular zone], containing engorged blood vessels. The maternal surface is [intact/lacerated/partially fragmented] with [complete/incomplete] cotyledons. Sectioning reveals dark red parenchyma with [few/multiple] lesions [describe] measuring [ x x ], located at [ cm] from disc edge. Thrombi and vascular communications [are/are not] present.

Placenta B:

Umbilical cord [B] is [ ] cm in length, [ ] cm in diameter, contains [two/three] blood vessels on cross-section and has a [central/para central or marginal insertion, marginal/velamentous/furcate] insertion. Spiral configuration of the umbilical cord is noted without knots or other focal abnormalities. The fetal membranes are [color], [translucent/opaque] and have [marginal/circummarginate/circumvallate] insertions. The placental portion of disc B measures [ x x ]. The fetal surface is [blue-gray] with [distinct vascular zones/indistinct vascular zones], containing engorged blood vessels. The maternal surface is [intact/lacerated/partially fragmented] with [complete/incomplete] cotyledons. Sectioning reveals dark red parenchyma with [few/multiple] lesions [describe] measuring [ x x ], located at [ cm] from disc edge. Thrombi and vascular communications [are/are not] present.

Representative sections are submitted in [9 cassettes]: [A1 = cord and membranes, placenta A; A2-A3 = placenta parenchyma, placenta A; A4 = representative section from lesion, placenta A; A5 = dividing membrane roll; A6 = cord and membranes, placenta B; A7-A8 = placenta parenchyma, placenta B; A9 = representative section from lesion, placenta B]

Twin placenta-two separate discs

Received without fixative labeled with the patient’s name “[ ]” and designated “[ ]” are two placental discs [connected by dividing membranes]. The dividing membranes are pink, glistening and translucent. Twin [A] is clinically identified by [one/two] umbilical cord clamp(s). Twin [B] is clinically identified by [one/two] umbilical cord clamp(s).

Placenta A:

Placenta [A] appears [oval/round], measures [ x x ] cm, and weighs [ ] g. Umbilical cord [A] is [ ] cm in length, [ ] cm in diameter, contains [two/three] blood vessels on cross-section and has a [paramarginal/paracentral/central/marginal/furcate/velamentous] insertion. Spiral configuration of the umbilical cord is noted without knots or other focal abnormalities. The fetal membranes appear [color], [translucent/opaque] and have [marginal/circummarginate/circumvallate] insertions. The fetal surface is blue-gray, smooth with engorged blood vessels. The maternal surface is [intact/lacerated/partially fragmented] with [complete/incomplete] cotyledons. Sectioning reveals dark red parenchyma with [few/multiple] lesions [describe] measuring [ x x ], located at [ cm] from disc edge. Thrombi and vascular communications [are/are not] present.

Placenta B:

Placenta [B] appears [oval/round], measures [ x x ] cm, and weighs [ ] g. Umbilical cord [B] is [ ] cm in length, [ ] cm in diameter, contains [two/three] blood vessels on cross-section and has a [central/para central or marginal insertion, marginal/velamentous/furcate] insertion. Spiral configuration of the umbilical cord is noted without knots or other focal abnormalities. The fetal membranes are [color], [translucent/opaque] and have [marginal/circummarginate/circumvallate] insertions. The fetal surface is blue-gray, smooth with engorged blood vessels. The maternal surface is [intact/lacerated/partially fragmented] with [complete/incomplete] cotyledons. Sectioning reveals dark red parenchyma with [few/multiple] lesions [describe] measuring [ x x ], located at [ cm] from disc edge. Thrombi and vascular communications [are/are not] present.

Placenta Twin, One Disc (Monochorionic or Fused Dichorionic), Twins A and B

One specimen is received *** (fresh/in formalin) labeled with the patient’s name and medical record number, consisting of *** (a single placental disc/two separate placentas) with attached umbilical cords and fetal membranes.

The twin A placenta is *** (or is not) identified by ***, and the other placenta is designated as twin B.

The *** (color) umbilical cord of twin A measures *** cm in length by *** cm in maximum diameter. It contains *** coils. It inserts centrally, *** cm from the disc margin, and contains *** on cut section. No true knots, edema, or other lesions are seen.

The *** (color) umbilical cord of twin B measures *** cm in length by *** cm in maximum diameter. It contains *** coils. It inserts centrally, *** cm from the disc margin, and contains *** on cut section. No true knots, edema, or other lesions are seen.

The *** (color) fetal membranes of twin A attach normally at the disc margin. The area of membrane rupture is located *** cm from the closest placental margin.

The *** (color) fetal membranes of twin B attach normally at the disc margin. The area of membrane rupture is located *** cm from the closest placental margin.

The round placental disc weighs *** grams and measures *** x *** x *** cm. The fetal surface is *** (color with a normal dispersion of the chorionic plate vessels. No thrombi are identified. Surface twin-twin arterial-arterial anastomoses and venous-venous anastomoses are not identified. Surface twin-twin arterial-venous anastomoses are not identified. The maternal surface is intact with no missing cotyledons. Adherent blood clot is identified, measuring *** x *** x *** cm, in aggregate. Serial sectioning through the placental disc at one centimeter intervals reveals spongy, dark red parenchyma with no lesions.

Representative sections are submitted as follows:

A1. twin A umbilical cord, fetal end, and membrane roll

A2. twin A umbilical cord, placental end, and chorionic plate section near cord insertion

A3. twin A placenta, central, full thickness section

A4. twin A placenta, full thickness section

A5. twin B umbilical cord, fetal end, and membrane roll

A6. twin B umbilical cord, placental end, and chorionic plate section near cord insertion

A7. twin B placenta, central, full thickness section

A8. twin B placenta, full thickness section

A9. interplacental membrane T-section

(A10-onward –any lesions)

PRODUCT OF CONCEPTION

Received without fixative labeled with the patient’s name “[ ]” and designated “[ ]” is a [ ] cm in aggregate of [tan/pink/red] membranous and soft tissue admixed with blood clot. No fetal parts or vesicles are identified. [A portion of the specimen is submitted to cytogenetics.] Representative tissue submitted in one cassette A1.

POC, Option 2

The specimen labeled “***” is received in formalin labeled with the patient’s name and medical record number and consists of multiple *** (color) fragments of soft tissue that measure *** x *** x *** cm in aggregate. Chorionic villi are grossly identified. Fetal tissue *** (is/is not) identified. The specimen is serially sectioned and submitted entirely in cassettes ***-***

UTERUS

General Benign Uterus

The fallopian [tube is/tubes are] pink-tan and tortuous [also describe any paratubal cysts, hydrosalpinx, etc.] and measure [#####] cm in length and [#####] cm in average diameter. The right ovary is yellow-white and lobulated [also include any cysts or masses] and measures [# x # x #] cm. The cut surface is [color and texture, cysts, masses]. The left ovary is yellow-white and lobulated [also include any cysts or masses] and measures [# x # x #] cm. The cut surface is [color and texture, cysts, masses]. Representative sections are submitted as follows:

[#####] Anterior cervix

[#####] Posterior cervix

[#####] Lower uterine segment

[#####] Anterior endomyometrium

[#####] Posterior endomyometrium

[#####] Right ovary

[#####] Right fallopian tube

[#####] Left ovary

[#####] Left fallopian tube

[#####] [Additional abnormalities]

Endometrial hyperplasia

Received [without fixative/in formalin] labeled with the patient’s name “[ ]” and designated “[ ]” is a uterus measuring [ ] cm in length, [ ] cm in width, [ ] cm antero-posteriorly and weighing [weigh without tubes and ovaries] g. The cervix measures [ ] cm in length and up to [ ] cm in width. The ectocervix is[tan/pink] and [smooth/describe.] The external os is [fishmouthed/circular/oval/pinpoint] and measures [ ] cm. The serosal surface is [smooth and glistening]. On opening, the endocervical canal measures [ ] in length and is surfaced by smooth mucosa [with Nabothian cysts]. The endometrial cavity is [symmetrical/distorted] and measures [ ] cm in length and [ ] cm from cornu to cornu. The endometrial cavity is surfaced by [smooth, pink] endometrium measuring up to [ ] cm in thickness. The myometrium is [tan/pink], ranges [ ] to [ ] cm in thickness, and contains [nodules/foci of hemorrhage].

The attached right fallopian tube measures [ ] cm in length, and ranges [ ] to [ ] cm in diameter, and is [fimbriated/not fimbriated]. The serosal surface is smooth and glistening. The lumen is not dilated [(if dilated, describe and measure)]. The attached right ovary measures [ x x ] cm. The capsular surface is [tan/pink/cerebreated]. Its cut surface is [tan/pink/soft/contains cysts].

The attached left fallopian tube measures [ ] cm in length, and ranges [ ] to [ ] cm in diameter, and is [fimbriated/not fimbriated]. The serosal surface is smooth and glistening. The lumen is not dilated [if dilated, describe and measure)]. The attached left ovary measures [ x x ] cm. The capsular surface is [tan/pink/cerebreated]. Its cut surface is [tan/pink/soft/contains cysts].

Specimen photographs are taken.

Representative sections are submitted as follows:

A1: anterior cervix;

A2: posterior cervix;

A3: anterior endomyometrium;

A4-A5: entire anterior endometrium, strips;

A6: posterior endomyometrium;

A7-A8: entire posterior endometrium, strips;

A9: nodule/hemorrhagic foci;

A10: right ovary;

A11: right fallopian tube;

A12: left ovary;

A13: left fallopian tube

Uterine prolapse

Received [without fixative/in formalin] labeled with the patient’s name “[ ]” and designated “[ ]” is a uterus measuring [ ] cm in length, [ ] cm in width, [ ] cm antero-posteriorly and weighing [weigh without tubes and ovaries] g. The cervix measures [ ] cm in length and up to [ ] cm in width. The ectocervix is [tan/pink] and [smooth/describe.] The external os is [fishmouthed/circular/oval/pinpoint] and measures [ ] cm. The serosal surface is [smooth and glistening]. On opening, the endocervical canal measures [ ] in length and is surfaced by smooth mucosa [with Nabothian cysts.] The endometrial cavity is [symmetrical/distorted] and measures [ ] cm in length and [ ] cm from cornu to cornu. The endometrial cavity is surfaced by [smooth, pink] endometrium measuring up to [ ] cm in thickness. The myometrium is [tan/pink], ranges [ ] to [ ] cm in thickness, and contains [nodules/foci of hemorrhage].

Specimen photographs are taken. Representative sections are submitted as follows:

A1: anterior cervix;

A2: posterior cervix;

A3: anterior endomyometrium;

A4: anterior endometrium, strips;

A5: posterior endomyometrium;

A6: posterior endometrium, strips;

A7: nodule/hemorrhagic foci;

A8: right ovary;

A9: right fallopian tube;

A10: left ovary;

A11: left fallopian tube

Leiomyomata (Intramural)

Received [without fixative/in formalin] labeled with the patient’s name “[ ]” and designated “[ ]” is a uterus measuring [ ] cm in length, [ ] cm in width, [ ] cm antero-posteriorly and weighing [weigh without tubes and ovaries] g. The cervix measures [ ] cm in length and up to [ ] cm in width. The ectocervix is [tan/pink] and [smooth/describe.] The external os is [fishmouthed/circular/oval/pinpoint] and measures [ ] cm. The serosal surface is [smooth and glistening]. On opening, the endocervical canal measures [ ] in length and is surfaced by smooth mucosa [with Nabothian cysts.] The endometrial cavity is [symmetrical/distorted] and measures [ ] cm in length and [ ] cm from cornu to cornu. The endometrial cavity is surfaced by [smooth, pink] endometrium measuring up to [ ] cm in thickness. The myometrium is [tan/pink], ranges [ ] to [ ] cm in thickness, and contains [one/multiple] nodules on the [anterior/posterior] myometrium, ranging from [ x x ] to [ x x ]cm. The cut surfaces of the nodules is [tan-white/whorled/hemorrhagic/calcified] with degenerative changes [present/absent].

Specimen photographs are taken. Representative sections are submitted as follows:

A1: anterior cervix;

A2: posterior cervix;

A3: anterior endomyometrium;

A4: posterior endometrium;

A5-A8: representative sections of the largest nodule;

A9-A10: representative sections from smaller nodules;

A11: other lesions/hemorrhagic foci;

A12: right ovary;

A13: right fallopian tube;

A14: left ovary;

A15: left fallopian tube

Endometrial cancer

On opening, the endocervical canal measures [ ] in length and is surfaced by smooth mucosa [with Nabothian cysts?.] The endometrial cavity is [symmetrical/distorted] and measures [ ] cm in length and [ ] cm from cornu to cornu. The [anterior/posterior/both] endometrial cavity is surfaced by a [tan/pink/hemorrhagic/exophytic/endophytic] mass measuring [ x x ] located [cm] from the [fundus/ectocervix]. The remaining endometrium is [smooth, pink] measuring up to [#] cm in thickness. Upon sectioning the mass has a [cm] gross invasion, corresponding to [more than/less than 50%] of the myometrium thickness. The remaining myometrium is [tan/pink/contains nodules].

Specimen photographs are taken. Representative sections are submitted as follows:

A1: anterior cervix;

A2: posterior cervix;

A3: full-face of the mass with deepest invasion;

A4-A5: additional sections of the mass;

A6: anterior endomyometrium, uninvolved ;

A7: posterior endomyometrium, uninvolved;

A8: other lesions/nodules/hemorrhagic foci;

A9: right ovary;

A10: right fallopian tube;

A11: left ovary;

A12: left fallopian tube

Endometrial Cancer, Option 2

Received [fresh, in formalin] and additionally labeled “uterus [and tubes and ovaries, if included]” is a uterus [with attached bilateral fallopian tubes and ovaries] which weighs [#####] grams and measures [#####] cm from cornu to cornu, [#####] cm from anterior to posterior, and [#####] cm from cervix to fundus. The serosal surface is smooth, pink-tan and glistening [also described additional features, e.g., leiomyomata]. The exocervix measures [# x # x #] cm and is covered by smooth glistening white mucosa. The external os is [circular, slit-like] and measures [#####] cm in diameter. The endocervical canal ([#####] cm in length) has a tan herringbone mucosa. The endometrial cavity ([# x #] cm) is red-tan and velvety and has an average thickness of [#####] cm. It contains a [# x #] cm polypoid mass. [The mass shows no gross invasion of the underlying myometrium (##cm thick).] [The mass demonstrates ##cm of invasion into the underlying myometrium (##cm thick), which is > or < 50%.] It [does/does not] grossly involve the cervix. The myometrium also demonstrates [describe any abnormalities in the myometrium: adenomyosis, leiomyomata, etc.].

Representative sections are submitted as follows:

[#####] Anterior cervix

[#####] Posterior cervix

[#####] Lower uterine segment

[#####] Mass with deepest extent of invasion

[#####] Anterior endomyometrium

[#####] Posterior endomyometrium

[#####] Right ovary

[#####] Right fallopian tube

[#####] Left ovary

[#####] Left fallopian tube

[#####] [Additional abnormalities]

Uterus for Cervical Cancer

Received [fresh, in formalin] and additionally labeled “uterus [and tubes and ovaries, if included]” is a uterus [with attached bilateral fallopian tubes and ovaries] which weighs [#####] grams and measures [#####] cm from cornu to cornu, [#####] cm from anterior to posterior, and [#####] cm from cervix to fundus. The serosal surface is smooth, pink-tan and glistening [also described additional features, e.g., leiomyomata]. The exocervix measures [# x # x #] cm and is partially distorted by a mass. The external os is [circular, slit-like] and measures [#####] cm in diameter. The mid anterior aspect of the cervix is designated 12 o’clock. There is a [# x # x #] cm ulcerated firm mass in the [o’clock] region of the cervix. The mass appears to invade to a depth of [#####] cm where the cervical wall thickness measures [#####] cm. The lesion extends into the endocervical canal but does not appear to involve the lower uterine segment or endometrium. The mass is [#####] cm from the nearest vaginal cuff margin. The endocervical canal ([#####] cm in length) has a tan herringbone mucosa. The endometrial cavity ([# x #] cm) is red-tan and velvety [also describe masses, leiomyomata, polyps] and has an average thickness of [#####] cm. The myometrial wall thickness is [#####] cm [describe any abnormalities in the myometrium: adenomyosis, leiomyomata, etc.]. The parametrial tissue contains no gross nodules or lymph node candidates.

The fallopian [tube is/tubes are] pink-tan and tortuous [also describe any paratubal cysts, hydrosalpinx, etc.] and measure [#####] cm in length and [#####] cm in average diameter. The right ovary is yellow-white and lobulated [also include any cysts or masses], and measures [# x # x #] cm. The cut surface is [color and texture, cysts, masses]. The left ovary is yellow-white and lobulated [also include any cysts or masses], and measures [# x # x #] cm. The cut surface is [color and texture, cysts, masses]. The entire cervix is submitted for histologic examination.

Sections are submitted as follows:

[#####] 12-3 o’clock cervix

[#####] 3-6 o’clock cervix

[#####] 6-9 o’clock cervix

[#####] 9-12 o’clock cervix

[#####] Vaginal cuff margin (if not included in cervix sections)

[#####] Right parametrium

[#####] Left parametrium

[#####] Lower uterine segment

[#####] Anterior endomyometrium

[#####] Posterior endomyometrium

[#####] Right ovary

[#####] Right fallopian tube

[#####] Left ovary

[#####] Left fallopian tube

[#####] [Additional abnormalities]

Fragmented uterus

Received [without fixative/in formalin] labeled with the patient’s name “[ ]” and designated “[ ]” is a fragmented uterus weighing [ ]g and measuring [ x x ] in aggregate with fragments ranging in size from [cm] to [cm]. The disrupted serosa is [tan/pink/smooth/glistening]. The endometrium is [disrupted/focally present] appears [tan/pink/lush] and upto [ ] in thickness. The myometrium ranges from [ ] to [ ] cm in thickness and is [tan/pink/homogenous/trabeculated/contains nodules] (if nodules present give range, describe cut surface).

Specimen photographs are taken. Representative sections are submitted as follows:

A1-A3: representative sections from largest fragment to include endometrium and serosa;

A4: representative section from smaller fragments;

A5-A6: representative from nodules/other findings

Morcellated Uterus, Option 2

Received fresh and additionally labeled “uterus and cervix” are multiple tan-white fragments of soft tissue ([#####] grams; [# x # x #] cm), grossly consistent with a morcellated uterus. The segments of tissue average [#####] cm in diameter, and range up to [#####] cm in greatest dimension. Identifiable structures include fibromuscular tissue with a possible endometrial lining, serosa, and possible cervix. Additional tan/white whorled fragments consistent with leiomyomata are identified but showed no evidence of hemorrhage or necrosis.

Representative sections are submitted as follows:

[#####] Endomyometrium

[#####] Myometrium and serosa

[#####] Possible cervix

[#####] Leiomyomata

OVARY

Teratoma

Received [without fixative/in formalin] labeled with the patient’s name “[ ]” and designated “[ ]” is an ovary measuring [ x x ] and weighing [ ] g. The capsular surface is [intact/disrupted] and is [tan/pink/corrugate]. The cut surface is [solid/cystic/solid and cystic] with cysts ranging from [ ] to [ ] and the solid component amounting to [ %] of the cut surface. The cut surface is [tan/hemorrhagic/ contains yellow exudative material/hair/teeth, etc].

Specimen photographs are taken. Representative sections are submitted in [# cassettes]: [A1-A3: representative sections of cystic areas; A4-A6: representative sections of solid component].

Ovarian cyst

Received [without fixative/in formalin] labeled with the patient’s name “[ ]” and designated “[ ]” is an ovary measuring [ x x ] and weighing [ ] g. The capsular surface is [intact/disrupted] and is [tan/pink/corrugate]. The capsular surface is inked [black]. The cut surface is [solid/cystic/solid and cystic] with cysts ranging from [ ] to [ ] and the solid component amounting to [ %] of the cut surface. The cysts are [multiloculated/uninoculated] and contain [clear/viscous fluid]. The locules range from [ ] to [ ] and the cyst lining are [tan/pink/smooth/with excrescences]. No area of hemorrhage or cyst wall thickening are identified.

Specimen photographs are taken. Representative sections are submitted in [# cassettes]: [A1-A3: representative sections of the largest locule; A4-A5: representative sections of solid/excrescent component; A6: representative sections of the smaller locule; A7: representative section from uninvolved ovary].

Ovarian Cyst, Option 2

Received fresh and additionally labeled “[#####]” is an intact [# x # x #] cm unilocular cystic structure with smooth inner and outer surfaces ([#####] cm in thickness also disease. The outer surface is inked black. A [# x # x #] cm area of white fibrotic tissue is present adjacent to the cyst, possibly representing residual ovarian tissue. The cyst is filled with clear serous fluid.

[#####] Sections of cyst wall

[#####] Possible residual ovarian tissue

Ovary with Complex Cyst

Received fresh and additionally labeled “[#####]” is an intact [# x # x #] cm multiloculated cystic mass, with adjacent ovarian tissue ([# x # x #] cm), and an attached fallopian tube ([# x # x #] cm). Most of the cyst wall is thin ([#####] cm) with focal areas of thickening that measure up to [#####] cm. The outer surface of the cyst is smooth and is inked black. Within the inner surface of the cyst there are multiple minute papillary excrescences (measuring up to [#####] cm in greatest dimension). The cysts are filled with tan viscous fluid. The adjacent ovarian tissue demonstrates [describe]. The fimbriated fallopian tube demonstrates paratubal cysts measuring up to [#####] cm.

[#####] Sections of cyst wall, including excrescences

[#####] Residual ovarian tissue

[#####] Fallopian tube

Ovary with Solid Mass

Received fresh and additionally labeled “[#####]” is an intact [# x # x #] cm solid mass with an attached fimbriated fallopian tube ([# x # x #] cm). The outer surface of the mass is smooth and encapsulated and is inked black. There are multiple small cysts of variable size (up to [#####] cm), but most of the mass is firm and solid with a mottled appearance ranging from dark red/brown to yellow. There [is/is not] residual ovarian parenchyma identified. The fimbriated fallopian tube demonstrates paratubal cysts measuring up to [#####] cm.

[#####] Sections of mass

[#####] Residual ovarian tissue

Ovarian mass

Received [without fixative/in formalin] labeled with the patient’s name “[ ]” and designated “[ ]” is an ovary measuring [ x x ] and weighing [ ] g. The capsular surface is [intact/disrupted] and is [tan/pink/corrugate]. The capsular surface is inked [black]. The cut surface shows a [ x x ]cm [tan/hemorrhagic/solid/cystic/solid and cystic mass] containing [exudate/hemorrhagic/clear/viscous fluid]. The mass is located [central part of ovary/abutting the capsule] and amounts to [%] of the cut surface. The remainder of the ovarian parenchyma is tan-pink and soft.

Specimen photographs are taken. Representative sections are submitted in [# cassettes]: [A1: full-face of the mass; A2-A4: additional representative sections of the mass; A5 representative section of uninvolved ovary]

FALLOPIAN TUBE

Prophylactic Salpingectomy (BRCA)

Received [without fixative/in formalin] labeled with the patient’s name “[ ]” and designated “[ ]” is a [fimbriated/non-fimbriated] fallopian tube, measuring [cm] in length and ranging [cm] to [cm] in diameter. The serosa is [tan/violet/smooth/congested] with [few/multiple] paratubal cysts ranging in size from [0.1] to [0.5]cm. The lumen is [dilated/pinpoint/unremarkable] (if dilated measure the area of dilatation and location from the fimbriated end).

Entirely submitted in [# cassettes]: [A1: fimbriae; A2-A3: cross sections]

Prophylactic Salpingo-Oophorectomy

Received fresh and additionally labeled “[#####]” is an ovary with attached fallopian tube and adnexa, measuring [# x # x #] cm. The ovary ([# x # x #] cm) has a smooth cerebriform surface. The cut surface demonstrates corpora albicantia. The fallopian tube is fimbriated and measures [# x # x #] cm; multiple paratubal cysts are present, measuring up to [#####] cm. The ovary and fallopian tube are entirely submitted for histologic examination.

[#####] Ovary

[#####] Fallopian tube fimbria

[#####] Fallopian tube cross sections

Hydrosalpinx/sterilization

Representative sections submitted in [# cassettes]: [A1: fimbriae; A2: cross sections to include dilated area]

CERVIX

Cervical truncation- benign

Received [without fixative/in formalin] labeled with the patient’s name “[ ]” and designated “[ ]” is an unoriented cervix, measuring [cm] in length by [cm] and [cm] in width. The ectocervix is [tan/pink/smooth/focally hemorrhagic]. The external os is [fishmouthed/circular/oval/pinpoint] and measures [ ] cm. The serosal surface is [smooth and glistening].

On opening, the endocervical canal measures [ ] in length and is surfaced by [smooth/corrugated] mucosa [with Nabothian cysts].

Specimen photographs are taken. Representative sections are submitted in [# cassettes]: [A1-A2: full-thickness sections of the cervix, one section per quadrant, 2 pieces per cassette]

Cervical truncation- polyp/cancer

Received [without fixative/in formalin] labeled with the patient’s name “[ ]” and designated “[ ]” is an oriented cervix designated by surgical suture [short/long] 12 o’clock and [short/long] 3 o’clock, measuring [cm] in length by [cm] and [cm] in width. The ectocervix is [tan/pink/smooth/focally hemorrhagic at x o’clock]. The external os is [fishmouthed/circular/oval/pinpoint] and measures [ ] cm. The serosal surface is [smooth/partially cauterized] and is inked [black].

On opening, the endocervical canal measures [ ] in length and contains a [tan/pink/exophytic/endophytic/ ill-defined/polypoid] lesion, measuring [ x x ]cm and located [cm] from the [ectocervix/os]. On sectioning the lesion appears [confined to the endocervical cavity/invades the cervical parenchyma with the deepest invasion measuring [cm]. The remainder of the endocervix is [tan/unremarkable/with Nabothian cysts].

Specimen photographs are taken. Representative sections are submitted in [# cassettes]: [A1-A2: ectocervix, one section per quadrant, 2 sections per cassette; A3-A4: Mass/polypoid lesion, entirely; A5: representative sections of uninvolved endocervical parenchyma].

Cervical Cone Biopsy

Received in formalin labeled “[#####]” is a [#####] cm cervical cone biopsy. The fragment of tissue contains a suture designating [#####] o’clock. [No orienting suture is identified.] The ectocervix measures [# x # x #] cm and demonstrates pink glistening mucosa. The endocervix is pink and granular. No gross lesions are identified. The ectocervical and deep margins are inked black; the endocervical resection margin is inked blue. The specimen is entirely submitted in [# cassettes] as follows:

[#####] 12-3 o’clock cervix

[#####] 3-6 o’clock cervix

[#####] 6-9 o’clock cervix

[#####] 9-12 o’clock cervix

GYN Grossing Templates

PLACENTA

UTERUS

OVARY

CERVIX