Take macroscopic photographs of the oriented thyroidectomy specimen prior to sectioning. Make sure the photographs show the following features, as demonstrated in the right image:
- A. The posterior aspect of the specimen.
- B. The anterior aspect of the specimen. There is a surgical suture designating the superior pole of the right lobe of the thyroid gland.
- C. The entire posterior aspect is inked black.
- D. The anterior aspect of the right lobe is inked red, the anterior aspect of the left lobe is inked green, and the isthmus is inked orange.
- E. The specimen is serially sectioned according to the map provided.
- F. There is a 0.4 x 0.4 x 0.3 cm ill-defined, pink-tan, irregularly-shaped, firm lesion that abuts black and green inked capsules in the mid-pole of the left lobe.
- The remaining thyroid parenchyma is dark red and grossly unremarkable.
Note: Please indicate the orientation ink code in the dictation for evaluation of the "capsule" / surface of the thyroidectomy specimen. There are 4 tissue marking dyes that were applied.
Dictation Template:
The specimen is received [fresh / in formalin], labeled with the patient's name, and designated on the requisition as “[total thyroid, right/left lobe of thyroid].” It is composed of a [weight] g total thyroidectomy specimen consisting of a right lobe measuring in [size] cm, a left lobe measuring [size] cm, and an isthmus measuring [size] cm. The specimen is received oriented [describe orientation, suture designating superior aspect of the right lobe]. The capsule of the thyroid gland is [intact, glistening, focally disrupted - location, with adherent adipose tissue]. No parathyroid glands or lymph nodes are grossly identified. [There are # pink-tan lymph node candidates ranging from 0.3 cm to 0.6 cm in greatest dimension identified in surrounding fibro-adipose soft tissue]. The specimen is inked as follows: anterior aspect of the right lobe – [color], anterior aspect of the left lobe – [color], anterior aspect of the isthmus – [color], and entire posterior aspect – [color]. The specimen is serially sectioned to reveal a [size] cm lesion in the [left or right] lobe. On cut section, the lesion is [cystic, soft, firm, rubbery, hemorrhagic, granular, circumscribed, encapsulated, discrete infiltrative, non-encapsulated] and [abuts the inked capsule, is __ cm from the nearest capsule]. The remaining thyroid parenchyma is otherwise [grossly unremarkable, soft, firm, rubbery, red-brown] and devoid of additional lesions. Gross photographs are taken.
Cassettes summary:
- [ ] - [ ]: entire right lobe from superior to inferior [without lesion, mass in blocks]
- [ ] - [ ]: isthmus [without lesion, mass in blocks]
- [ ] - [ ]: entire left lobe from superior to inferior [without lesion, lesion in blocks]
- [ ]: [number] lymph nodes
- [ ]: entire capsule of lesion
(Grossed by [Prosector’s Name])
