Uterus
Miscellaneous tumors
Grossing hysterectomy specimens

Author: Nat Pernick, M.D. (see Authors page)

Revised: 7 February 2017, last major update September 2011

Copyright: (c) 2002-2017, PathologyOutlines.com, Inc.

PubMed search: histologic sampling hysterectomy

Cite this page: Grossing hysterectomy specimens. PathologyOutlines.com website. http://pathologyoutlines.com/topic/uterusgrossing.html. Accessed December 12th, 2017.
Procedure (tumor)
  • Measure, weigh, describe, photograph
  • Open along lateral sides
  • Ink serosa adjacent to tumor, vaginal margin of resection
  • Section from endocervical canal to superior aspect
  • If cervical tumor present / suspected, amputate cervix and process as cone biopsy
Sections to obtain
No significant gross pathology:
  • Anterior and posterior cervix (important for identifying carcinoma in situ, J Clin Pathol 2002;55:629)
  • Anterior and posterior endomyometrium
  • Lower uterine segment
  • Each ovary (cortex, hilar region) and fallopian tube
  • Any gross lesions, including leiomyomas

Suspected tumor:
  • Above, plus:
  • With tumor, full thickness endomyometrium and serosa to assess depth of invasion
  • 1 section per 1 cm of tumor, minimum 3 sections
  • All grossly different appearing regions of tumor
  • High endocervical canal or lower isthmus
  • Ink and obtain margins of resection, including vaginal mucosa

  • Notes: in laparoscopic hysterectomies, pathologists may create artifactual vascular invasion by mechanically transporting tumor into vascular spaces during the grossing process (Am J Surg Pathol 2009;33:298)
  • May be difficult to identify specific cervical anatomic regions in morcellated specimens (Indian J Pathol Microbiol 2010;53:634)
Gross images / diagrams

Images hosted on other servers:

IARC: various images for grossing protocol

Morcellated specimen:
endometrium identified
as a slit-like space