Liver & intrahepatic bile ducts
General
Grossing, frozen section & features to report
Author: Deepali Jain, M.D.
Last author update: 1 February 2012
Last staff update: 17 April 2024
Copyright: 2002-2024, PathologyOutlines.com, Inc.
PubMed Search: Gross liver
Table of Contents
Grossing | Frozen section | Features to report - gross | Features to report - microscopic description | Features to report - organizations | Fat in donor liver biopsiesCite this page: Jain D. Grossing, frozen section & features to report. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/livertumorgrossing.html. Accessed December 23rd, 2024.
Grossing
- At least one section per 2 cm of tumor for large tumors, including tumor center and periphery
- Submit entire tumor, if can do so in 5 sections or less
- Adjacent and distant uninvolved liver
- Resection margins
- Portal and hepatic veins
- Porta hepatis
- Lymph nodes
- Gallbladder, if present
- Other tissues or organs
- Save intervening levels on biopsies for special stains
Frozen section
- Click here for the frozen section procedure topic
- Accurate and reliable for intraoperative diagnosis of suspected liver lesions - biliary hamartoma is most common entity confused with a malignant tumor (J Clin Pathol 2006;59:352)
- Pretransplant frozen section also used to evaluate donor livers for macrovesicular steatosis, although discrepancies exist with permanent sections in 7% (J Clin Med Res 2011;3:191)
- Optimally, should have clinical data and serum AFP levels available
- Should know if specimen is from a mass
Features to report - gross
- Tumor location (left, right or both lobes), tumor margin as circumscribed or infiltrative
- Presence of hemorrhage, necrosis, central scar and bile
- Extension to adjacent structures
- Other unusual features: unusually large cirrhotic nodules
- References: Arch Pathol Lab Med 2000;124:41, CAP: Protocol for the Examination of Specimens from Patients with Hepatocellular Carcinoma [Accessed 6 December 2017]
Features to report - microscopic description
- Tumor histologic type, tumor grade (specify grading system) and pattern
- Number and size (3 dimensions) of tumor nodules
- Status of resection margins (ask surgeon which margins are important to evaluate)
- Severity of fibrosis (none, mild, moderate, severe, cirrhosis)
- Angiolymphatic invasion
- Mitotic rate
- Findings in nonmalignant liver, including cirrhosis, iron deposition, other tumors, portal vein thrombosis, hepatocyte dysplasia and hepatitis
- Regional lymph nodes: number examined, number and location with metastatic tumor
Features to report - organizations
Fat in donor liver biopsies
