• The vast majority of LEEP is performed for high-grade cervical dysplasia. Therefor the margins are important.
• The speciment may be in the shape of a cone (with the point of the cone pointing to the endometrial cavity) or in fragments.  Under optimal circumstances, cones are oriented, usually with a suture marking the 12 o’clock position.  Fragmented specimens are usually unoriented.
• Measure cones in 3 dimensions, including the surface diameter of the ectocervix (cm x cm) and depth (from the ectocervix to the endocervical margin).  Measure (3 dimensions) each individual piece of a fragmented specimen.
• Describe the overall tissue (color, shape, fragmentation) and os (diameter, shape), as well as any lesions (ulcer, mass, hemorrhage, defect, cyst, laceration; include measurements of lesions).
• Ink the surgical margins.  The point of the cone (i.e. tip of the endocervical canal) should be inked with a different color than the rest of the margin.  If you cannot determine the margins on a fragmented specimen, ask a staff pathologist for help.
• Section the cone in a radial, clockwise fashion, beginning at the 12 o’clock position.  If there is no orientation, start at an anatomic landmark (e.g. a lesion or sharp angle in the tissue), if possible, and mention this in your dictation.  Each section should resemble a wedge of pie.  It is critical to submit all of the mucosa in this manner; however, in very large specimens, excess stroma may be trimmed and submitted separately.
• Fragmented specimens should be sectioned perpendicularly to the mucosal surface, in a manner similar to that described above for cones.

• Submit all tissue, with a maximum of two sections per cassette.  Sections should be approximately the same thickness.
• Cones:  submit one or two sections per cassette (depending on section size), beginning from 12 o’clock and proceeding clockwise.
• Unoriented fragments:  submit each sectioned fragment in its own cassette(s).

Received in formalin, labeled with patient name, medical record number and “cervix”, is a __ cm long cervical cone, with a __ to __ cm diameter, marked at ___ o'clock position by a suture. There ectocervical surface is white/pink with superficial errosions at ___ o'clock position. The transition zone is well-defined/irregular with hemorrhage/ulceration.  The endocervical mucosal is pink tan/focally erroded. __ to __ cm in diameter mucin-filled cysts / polyps are present.  The endocervical margin is inked blue and the ectocervical and stromal margins are inked black.  A total of ___ radial serial sections are entirely submitted in clockwise order in 6 cassettes as follows.

#__ & #__ = __ to __ o'clock, __ fragments each.

#__ & #__ = __ to __ o'clock, __ fragments each.

#__ & #__ = __ to __ o'clock, __ fragments each.

Received in formalin, labeled with patient name, medical record number and “cervix”, is a 0.5-cm thick LEEP specimen with a central __ x __ cm slit-like os surrounded by a complete __ cm rim of cervix with a suture marking the 12 o’clock position.  The ectocervical mucosa is white / tan-pink and smooth with focal granularity. The endocervical margin is inked blue and the ectocervical and stromal margins are inked black.  The specimen is serially sectioned radially clockwise from 12:00 and entirely submitted in ___ cassettes.

#__ & #__ = __ to __ o'clock, __ fragments each.

#__ & #__ = __ to __ o'clock, __ fragments each.

#__ & #__ = __ to __ o'clock, __ fragments each.

__ blocks, __ H&E.