• Measure the specimen (three dimensions).
• If the lymph node is > 0.5 cm, serially section it into 0.15 - 0.2 cm slices parallel to the longitudinal axis (as you would for a metastatic carcinoma work-up).  If the lymph node is < 0.5 cm, bisect it.
• Describe the cut surface (color, consistency, presence of blue dye), paying particular attention to areas suspicious for tumor.
• If interoperative consultation is requested by the surgeon, proceed as follows:
• If a focus suspicious for tumor is present:  perform frozen section on the slice containing that focus.
• If no suspicious focus is present:  perform frozen section on one representative slice.
• Fix in formalin.

• Entirely submit.
• Request 5 levels on each block – H&E on levels 1, 3 and 5 and unstained on levels 2 and 4 (to be held in reserve in case immunohistochemistry studies are needed).

Internal use only

Received without fixative/in formalin, labeled with patient's name, medical number and “_____”, is a __ x __ x __ cm of yellow fibroadipose tissue containing __ (number) discrete/matted lymph nodes ranging from __ cm to __cm.  The lymph node capsules are _____ (intact, inapparent).  Each lymph node has a _____ (color, fleshy, bulging, soft, firm, multinodular, necrotic, hemorrhagic) cut surface focally stained with blue dye, with a __ cm focus suspicious for tumor.  Entirely submitted as follows: 

FS#__ = suspicious focus; #__- #__ = remainder of tissue.

Five levels of each block; levels 1, 3, and 5 = H&E; levels 2, 4, and 6 = unstained

__ blocks, __ H&E, __ frozen section,