• Distal pancreatectomy usually performed for tumors (neuroendocrine, mucinous cystic neoplasm). Specimen includes the tail of the pancreas (with or without the body) and the spleen.
• Measure each component (.e.g. the pancreas and spleen. 
• Weigh the spleen (if it is en bloc with the pancreas, weigh the spleen separately after specimen dissection is complete).
• Identify and dissect lymph nodes in the unfixed state.
• Ink the proximal pancreatic resection margin and any additional soft tissue margins (use different colors for anterior and posterior).
• Probe pancreatic duct and bivalve the pancreas into anterior and posterior halves. 
• If a (mucinous) cystic lesion is present, determine whether it is connected to the pancreatic duct!
• Measure the tumor and its distance to the proximal resection margin. 
• Describe the tumor (solid vs. cystic, color, shape, circumscription, necrosis). 
• Describe the uninvolved pancreatic parenchyma (fat necrosis, parenchymal atrophy, fibrosis). 
• Serially section the spleen, keeping it attached to the pancreas. 
• Note whether it is involved by tumor.  Describe the splenic parenchyma (color, consistency, nodularity).
• Take photographs.
• Pin the specimen to a board, submerge in formalin, and fix it for a few hours or overnight if necessary before taking sections.

• Pancreatic resection margin:  entirely submit, cross section.
• Additional soft tissue margins:  representative sections (if not already included with tumor sections).
• Tumor:  minimum of six sections, showing relationships to adjacent structures.
• Uninvolved pancreas:  two sections.
• Uninvolved spleen:  two sections.
• Lymph nodes:  entirely submit, labeling according to location/lymph node group.

Internal use only

Received without fixative/in formalin, labeled _____ and “_____”, is a __ x __ x __ cm portion of distal pancreas with attached __ x __ x __ cm, __ g spleen.  The pancreatic duct at the proximal margin is identified.  The posterior aspect of the pancreas is inked black and the proximal resection margin is inked blue.  There is a __ x __ x __ cm, _____ (color, circumscription, texture, solid, multicystic) mass within the pancreas, __ cm from/extending to the proximal pancreatic resection margin.  The soft tissue surrounding the external surface of the pancreas is _____ (color, fatty, fibrotic, necrotic, uninvolved by tumor, focally/extensively involved by tumor).  The uninvolved pancreas is _____ (color, lobulated, fibrotic).  The splenic capsule is _____ (smooth, fibrotic, covered with adhesions, lacerated).  The spleen has a _____ (color, consistency) cut surface with _____ (a few firm white nodules from __ to __ cm in diameter, extensive infiltration by tumor).  Multiple _____ (color, consistency) lymph nodes are identified, ranging from __ to __ cm in maximum dimension.   The pancreatic resection margin is inked _____, the anterior peripancreatic soft tissue margin is inked _____, and the posterior peripancreatic soft tissue margin is inked _____.  Photographs are taken.  Representative sections are submitted as follows:

#___ & #___ = proximal pancreatic resection margin with the pancreatic duct, ___ pieces

#___ - #___ =  mass and adjacent pancreas with posterior margin, 1 piece / cassette.

#___ & #___ = mass and adjacent structure (e.g. spleen or splenic vessel)

#___ & #___  = ___ posterior peripancreatic lymph nodes, ___ intact nodes/cassette.

#___ & #___  = ___ inferior peripancreatic lymph nodes, bisected, ___ nodes/cassette..

#___ = representative uninvolved pancreas, ___ pieces.

#___  =  spleen, ___ pieces

#___ - #___ = mass and adjacent ampulla of Vater.

#___ - #___ = mass and adjacent structures (e.g. common bile duct, duodenum / stomach, etc.).

#___ = uninvolved pancreas.

#___ = uninvolved duodenum.

#___ = uninvolved stomach.

#___ - #___ = __ lesser curvature lymph nodes (___ per cassette)

#___ - #___ = __ superior peripancreatic lymph nodes (___ per cassette)

__ blocks, __ H&E