• This section pertains to specimen including cecum.  For general guidelines, see section "Bowel: Resection for Tumor, General". 
• Note the epicenter of the tumor -- peritonealized (anterior) wall or non-pertonealized (posterior).
• Note the presence or absence of the appendix and whether it is involved by tumor.  If uninvolved, process as in Appendectomy.

• Tumor:  minimum of five transmural sections with adipose tissue (if tumor is very thick, you may need to divide a section into two cassettes – superficial and deep).  Include adjacent uninvolved mucosa in some sections.  Villous adenomas may require extensive sampling to rule out invasion.
• Resection margins:
• Proximal and distal:  en face (representatively submitted) if more than 2 cm from tumor; perpendicular (representatively submitted) if 2 cm or less from tumor. 
• Radial/deep margin:  include with tumor sections if possible; otherwise, two sections closest to deep portion of tumor.
• Uninvolved colonic wall:  two sections from different areas, taken perpendicular to the folds.  Additional sections of lesions.
• Polyps:  entirely submit, cut in half longitudinally so that each half includes both polyp and stalk with colonic wall.  Continue to serially section at 3 mm intervals in the same plane of sectioning, if necessary.
• Appendix:  tip and two cross sections in one block, if present.
• Lymph nodes:  entirely submit, designated as to location with regard to tumor.

Received fresh labeled "transverse colon" is a looped, unoriented segment of colon measuring __ cm in length with an internal circumference of 8 cm. The serosa is tan and ragged with delicate fibrous adhesions and a __ x __ x __ cm attached portion of yellow, finely lobulated omentum. There is also a 3 cm ragged, puckered area (inked blue) without features of attachment to other organ. The specimen is opened to reveal a __ x __ x __ cm centrally ulcerated mass with heaped up borders located at least 5 cm from one margin, at least __ cm from the other margin, and 4 cm from the closest mesenteric margin. The mass grossly invades through the muscularis propria and slightly into the underlying adipose tissue. The remainder of the mucosa is tan and normally folded.

Upon dissection of the attached adipose tissue, __ possible lymph nodes are identified ranging from __ cm to __ cm.

Representative sections are submitted as follows:

1-2 - both margins shaved reverse en face

3 - closest mesenteric margin shaved reverse en face

4 - representative sections of unremarkable omentum

5-6 - mass invading into underlying adipose tissue      

7-9 - mass to puckered, blue inked serosa        

10 - mass to normal mucosa                             

11 - six possible lymph nodes

12 - six possible lymph nodes

13 - four possible lymph nodes

14 - three possible lymph nodes

15 - two possible lymph nodes, each bisected

__ blocks, __ H&E

Received in formalin labeled with patient's name and "right colectomy" is a ileocolectomy specimen consisting of ___ cm of terminal ileum and ___ cm of cecum and ascending colon with __cm non-adhering serosal puckering area in anterior colon. The attached appendix is ___ cm long and ___ cm in diameter. The ileum is unremarkable and averages ___ cm in circumference. The ileocecal valve is slightly lipomatous but otherwise unremarkable. There is a ___ x ___ cm firm, tan-red plaque-like ulcerated/fungating mass on the posterior/lateral non-pertonealized wall of the cecum / ascending colon and is ___ cm from the proximal margin and ___ cm from the distal margin. It grossly extends the full thickness of the wall and is 0.4 cm from the sidewall margin (inked black). It also is ___ cm from the puckering serosal surface (inked blue) and ___ cm from the mesenteric margin. The remaining colon is unremarkable and averages ___ cm in circumference.  ___ possible lymph nodes (of which __ within 5 cm from the mass) are identified.

Representative sections are submitted as follows:

#___ = proximal resection margin  (cross section).

# ___ = distal resection margin (cross section).

#___ = shaved mesenteric margin).

#___ and #___ = mass with sidewall margin.

#___ and #___ = mass with puckering serosa (inked blue).

#___ and #___ = additional sections of the mass.

#___  = ileocecal valve

#___ = uninvolved ileal and colonic mucosa .

#___ - #___ = appendix

#___- # ___ = ___ lymph nodes within 5 cm proximal from the mass (__ node per cassette).

#___- # ___ = ___ lymph nodes within 5 cm distal from the mass

___ lymph nodes further than 5 cm from the mass.

__ blocks, __ H&E