Received without fixative/in formalin, labeled _____ and " _____ " is a Whipple resection specimen including distal stomach, duodenum, head of the pancreas, and common bile duct stump. The stomach is __ cm along the lesser curvature, __ cm along the greater curvature, and __ cm in wall thickness. The duodenum is __ cm in length, __ cm in average circumference, and __ cm in wall thickness. The pancreas is __ cm in length and __ x __ cm in cross-sectional area. The common bile duct stump is __ cm in length and __ cm in diameter at the margin. The posterior pancreatic margin is inked black and the distal pancreatic margin is inked blue. When opened, the gastric and duodenal mucosa shows ____ (e.g. no ulcer, mass, flattening). The ampulla of Vater is identified and the duct is opened to show a ___ cm diameter ampulla (with ____). Serial sectioning of the pancreas reveals a _____ (color, consistency, shape) pancreatic/common bile duct/_____ (peri-) ampullary mass located __ cm from the distal pancreatic/bile duct/duodenal resection margin. The pancreatic duct/bile duct is patent/obstructed by the mass/dilated to __ cm. The mass is __ cm from/infiltrates the ampulla of Vater. The posterior retroperitoneal margin and anterior peritoneal surface are _____ (color, fatty, fibrotic, necrotic), with/without involvement by the mass. The uninvolved pancreas is _____ (color, consistency). Multiple _____ (color, consistency) lymph nodes are identified in the soft tissue around the organs, ranging from __ to __ cm in greatest dimension. Two lymph nodes in the superior peripancreatic soft tissue, __ and __ cm in diameter, respectively, are firm and white-tan. The distal pancreatic, posterior retroperitoneal, common bile duct, gastric, and duodenal margins are inked black. Photographs are taken.
#___ - #___ = distal pancreatic resection margin, anterior and posterior half, respectively
#___ - #___ = retroperitoneal pancreatic margin, en face (if grossly distant from tumor mass)
#___ = common bile duct margin, cross section.
#___ = representative proximal gastric/duodenal margin.
#___ = representative distal duodenal margin.
#___ - #___ = mass and adjacent pancreas with posterior margin
#___ - #___ = 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