BREAST, LEFT WITH LEVEL II AXILLARY LYMPH NODES

Received in formalin is a specimen labeled “breast, left with level II lymph nodes” weighing 790 grams
with the breast measuring 18 x 15 x 4 cm. The skin ellipse measures 16 x 4.5 x 0.3 cm with a
hyperpigmented area on the upper outer quadrant measuring 4.0 cm in diameter. The rest of the skin
has no other lesions. The nipple-areola complex measures 6.4 cm in diameter with no retraction or
discharge. Cut sections show a cream-white, firm, irregular and mostly hemorrhagic mass measuring 4.0
x 4.0 x 3.0 cm located at the upper outer quadrant and beneath the hyperpigmented skin. Some fibrosis
is present. The mass is located 4.0 cm from the superior, 7.0 cm from the lateral, 5.0 cm from the
inferior, 6.0 cm from the medial and 0.2 cm from the basal resections margins, and 6.0 cm from the
nipple-areola complex. The axillary tail is detached and fragmented measuring 9.0 cm in aggregate
diameter. Several lymph nodes are present measuring from 0.2 x 0.1 x 0.1 cm to 1.9 x 1.0 x 0.5 cm.
Sections are taken and labeled as follows:

A1-A3. Widest dimension of the mass and basal margin. Block 3 (3).
A4. Representative sections. Block 2 (1).
A5. Nipple-areola complex. Block 1 (1).
A6-A9. Lymph nodes. Block several (4).

Breast, left, with level II axillary lymph nodes, modified radical mastectomy:

RIGHT BREAST

Received in formalin is a specimen labeled “right breast” weighing 1400 grams and measuring 17 x 15 x
14 cm. The skin measures 18 x 17 x 0.4 cm with a dark-red and firm fungating mass measuring 8 x 6 x 4
cm. Cut sections of the breast show cream-white to yellow, firm and lobulated mass almost entirely
replacing the breast parenchyma and is continuous with the fungating skin mass. There are areas of
cystic changes filled with mucoid material. Areas of hemorrhage are also seen. The mass is located about
0.1 cm from the nearest resection margin. The nipple-areola complex is not identified. No lymph nodes
retrieved. Sections are taken and labeled as follows:

A1-A4. Mass. Block 16 (4).

A5. Skin with mass. Block 2 (1).
A6. Margin A. Block 1 (1).
A7. Basal margin. Block 1 (1).

Right breast, simple mastectomy right with thoracoabdominal flap:

A) ESOPHAGEAL MUCOSA; B) ASCENDING COLON POLYP; C) RECTAL POLYP

Received in formalin are three (3) specimens:

A. Labeled “esophageal mucosa” which consists of one (1) cream-white, soft and irregular tissue
fragment measuring 0.7 x 0.2 x 0.1 cm. Block all (1).
B. Labeled “ascending colon polyp” which consists of one (1) cream-white, soft and irregular tissue
fragment measuring 0.4 x 0.2 x 0.1 cm. Block all (1).

C. Labeled “rectal polyp” which consists of two (2) cream-white, firm and irregular tissue fragments
measuring 0.3 x 0.2 x 0.1 cm and 0.6 x 0.2 x 0.1 cm. Block all (1).

A. Esophageal mucosa, gastroscopy:

B. Ascending colon polyp, colonoscopy with biopsy:

C. Rectal polyp, colonoscopy with biopsy:

THYROID

Received in formalin is a specimen labeled “thyroid” weighing 14.9 grams. The right lobe, left lobe and
isthmus measures 6 x 3 x 2 cm, 3.8 x 2.5 x 1.9 cm and 3 x 1.7 x 0.7 cm, respectively. The outer surface is
brown-red and fairly smooth. Cut sections show several nodules of colloid with occasional hemorrhage
and calcifications measuring from 0.7 x 0.5 x 0.5 cm to 1.0 x 1.0 x 0.7 cm. Sections are taken and labeled
as follows:

A. Right lobe. Block 4 (1).

B. Left lobe. Block 4 (1).
A3. Isthmus. Block 3 (1).

Thyroid, total thyroidectomy:

STOMACH BODY

Received in formalin is a specimen labeled “stomach body” which consists o several cream-white to tan-
pink, soft to firm and irregular tissue fragments with an aggregate diameter of 0.7 cm. Block all (1).

Stomach body, esophagogastroduodenoscopy with biopsy:

ENDOCERVICAL CURETTINGS

Received in formalin is a specimen labeled “endocervical curettings” which consists of several cream-
white to tan-pink, firm and irregular tissue fragments with blood clots measuring 5.1 cm in aggregate
diameter. Block all (2).

Endocervical curettings, cervical punch biopsy with curettage:

GALLBLADDER WITH STONES

Received in formalin is a previously-incised specimen labeled “gallbladder with stones” measuring 5.5
cm in length, 2.0 cm in diameter and 0.2 to 0.5 cm in wall thickness with a cream-white and dull serosa.
The mucosa is green and velvety with several cream-yellow flecks. At the neck are several black stones
with an aggregate diameter of 1.0 cm. Block 3 (1).

Gallbladder with stones, laparoscopic cholecystectomy:

PERIANAL MASS

Received in formalin is a specimen labeled “perianal mass” which consists of two (2) cream-white, firm
and irregular tissue fragments measuring 1.0 x 0.7 x 0.6 cm and 1.2 x 1.0 x 0.5 cm. Cut sections show a
cream-white to tan-pink and solid surface. Block all (1).

Perianal mass, incision biopsy:

A) ESOPHAGEAL MUCOSA; B) GASTRIC ULCER EDGE; C) SIGMOID COLON POLYP; D) RECTAL POLYP

Received in formalin are four (4) specimens:

A. Labeled “esophageal mucosa” which consists of one (1) cream-white, soft and irregular tissue
fragment measuring 0.6 x 0.2 x 0.1 cm. Block all (1).

B. Labeled “gastric ulcer edge” which consists of one (1) cream-white, soft and irregular tissue fragment
measuring 0.3 x 0.3 x 0.1 cm. Block all (1).
C. Labeled “sigmoid colon polyp” which consists of four (4) cream-tan, firm and irregular tissue fragment
measuring from 0.2 x 0.2 x 0.1 cm to 0.4 x 0.3 x 0.2 cm. Block all (1).

D. Labeled “rectal polyp” which consists of several cream-tan to tan-pink, soft and irregular tissue
fragment with an aggregate diameter of 0.7 cm. Block all (1).

A. Esophageal mucosa, biopsy:

B. Gastric ulcer edge, biopsy:

C. Sigmoid colon polyp, biopsy:

D. Rectal polyp, biopsy:

SIGMOID POLYP

Received in formalin is a specimen labeled “sigmoid polyp” which consists of one (1) cream-tan, soft and
irregular tissue fragment measuring 0.4 x 0.2 x 0.1 cm. Block all (1).
Sigmoid polyp, colonoscopy with biopsy: