Grossing

Lorum ipsum

Margins

Present on all resections to document the presence or absence of tumour and/or viability of the resection margin 📕

En face (shave, parallel)

Advantages

• more surface area
• entire structures can be evaluated (e.g., bronchus, ureter)

Disadvantages

• cannot measure the exact distance
• can be difficult to interpret when cautery artifact is present

Perpendicular

Advantages

• exact distance can be measured

Disadvantages

• very little tissue is evaluated in larger resections

Rule of thumb: if the margin is < 2 cm away in a resection, submit perpendicular. If not, consider the value in allowing the pathologist to evaluate the entire margin in a single cassette

Cardiac Valves

Degenerative Calcific Aortic Valve stenosis. Calcified at the base, usually not cuspal edges. Cusps may be heavily fibrosed and thickened but not fused. Congenital bicuspid valves are predisposed to degenerative calcification. Usually one of the cusps is larger with a midline raphe resulting from the incomplete separation of two cusps. The raphe is often the site of extensive calcification 📕

"Calcific aortic stenosis occurring on a congenitally bicuspid valve. One cusp has a partial fusion at its center, called a raphe" 📘